Singh Y P, Sayami P
Department of Surgery, Institute of Medicine, TUTH, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2009 Jul-Sep;48(175):252-7.
Breast cancer is the second most common malignancy among women in Nepal. It is more common in young premenopausal women. Breast cancer continues to increase in incidence due to lifestyle changes in Nepalese women despite constant remarkable development in the management of this disease over the past three decades. Breast cancer was diagnosed solely clinically and surgery was the only treatment option until fifty years ago. Multidisciplinary approach has been adopted for diagnosis and treatment of breast cancer in Nepal. Imaging is required for the diagnosis, appropriate treatment decision and proper follow up. Treatment modality depends upon the extent of the disease and tumor biology. However, there is a strong need for standard guidelines for the proper management of breast cancer in Nepal so that surgeries, chemotherapy, hormone therapy and radiotherapy are standardized in the country. Palliative care has been initiated to provide to some patients with metastatic breast cancer recently. The breast cancer management in Nepal is a little different when compared with the centers in the developed countries. The reasons are socioeconomic status, lack of education and lack of facilities. Although cancer care is on the rise in Nepal, the optimal facility for centers managing breast cancer has to be improved significantly.Cancer education, screening and early detection are the key elements to influence the diagnosis, treatment and prognosis of breast cancer in Nepal. Breast cancer awareness and clinical breast examination are important tools for early detection in our resource limited context. Breast cancer can be cured in majority of the cases if diagnosed in early stages. This review will focus on relevant patient data along with future recommendation regarding breast cancer treatment in Nepal.
乳腺癌是尼泊尔女性中第二常见的恶性肿瘤。它在年轻的绝经前女性中更为常见。尽管在过去三十年中乳腺癌的治疗取得了显著进展,但由于尼泊尔女性生活方式的改变,其发病率仍在持续上升。直到五十年前,乳腺癌仅通过临床诊断,手术是唯一的治疗选择。尼泊尔已采用多学科方法来诊断和治疗乳腺癌。诊断、做出适当的治疗决策以及进行适当的随访都需要影像学检查。治疗方式取决于疾病的程度和肿瘤生物学特性。然而,尼泊尔迫切需要关于乳腺癌合理管理的标准指南,以便在该国实现手术、化疗、激素治疗和放射治疗的标准化。最近已开始为一些转移性乳腺癌患者提供姑息治疗。与发达国家的中心相比,尼泊尔的乳腺癌管理略有不同。原因是社会经济地位、教育程度低和设施匮乏。尽管尼泊尔的癌症治疗正在兴起,但管理乳腺癌的中心的最佳设施仍需大幅改善。癌症教育、筛查和早期检测是影响尼泊尔乳腺癌诊断、治疗和预后的关键因素。在我们资源有限的情况下,提高乳腺癌意识和进行临床乳腺检查是早期检测的重要手段。如果在早期阶段诊断出乳腺癌,大多数情况下是可以治愈的。本综述将重点关注相关患者数据以及关于尼泊尔乳腺癌治疗的未来建议。