Mohiuddin M, Gafur M A, Karim M R, Khan S A, Hoque M M, Islam M S, Ali M S
Department of Anatomy, Mymensingh Medical College (MMC), Mymensingh, Bangladesh.
Mymensingh Med J. 2012 Apr;21(2):238-45.
Carcinoma of breast is the second most common cancer among women next to uterine cervical cancer in Bangladesh. It was well established that 5 years survival rates greatly vary among the different stages of carcinoma of breast disease. The study was carried out to see the stages of presentation of carcinoma of breast patient to a tertiary level hospital attended first time for medical help as well as to find out the factors responsible for the late (advanced) stage presentation. This descriptive type of cross sectional study was carried out in the department of surgery, Mymensingh Medical College and Hospital (MMCH) during the period of May 2010 to April 2011. A total of 110 cases admitted with carcinoma breast diagnosed by means of FNAC positive or suspicious findings were selected purposively during the study period. Patients were staged initially according to the TNM staging system by through clinical examination as well as final clinicopathological stages were done after histopathological examination of the resected specimen (breast with or without axillary lymphnode) in resectable cases. Among the advanced stage presentation, attempts were made to find out the factors responsible for advanced stage of the disease. The results showed that carcinoma of breast predominantly a disease of female and comparatively younger age group 40-49 years affected mostly in 40.9% cases with a mean age of 44.02 ± 10.32 years. Premenopausal lady mostly affected in 63.6% cases. Majority of patients presented in advanced stage of the disease in 62.8% cases. Multiple factors were observed responsible for the advanced stage of the disease - among them delay in hospital presentation, poor socioeconomic condition and illiteracy have found to be associated which were statistically significant (p<0.001). It was needed for mass awareness program against the breast cancer in our society. Necessary steps should be taken for the initiation of breast self examination (BSE) to patients and clinical breast examination (CBE) to health care providers.
在孟加拉国，乳腺癌是女性中仅次于子宫颈癌的第二大常见癌症。众所周知，乳腺癌不同阶段的5年生存率差异很大。本研究旨在观察首次前往三级医院寻求医疗帮助的乳腺癌患者的就诊阶段，并找出导致晚期（进展期）就诊的因素。这项描述性横断面研究于2010年5月至2011年4月在迈门辛医学院医院（MMCH）外科进行。在研究期间，有目的地选择了110例经细针穿刺抽吸活检（FNAC）确诊为阳性或可疑结果的乳腺癌住院病例。患者最初通过临床检查根据TNM分期系统进行分期，对于可切除病例，在对切除标本（有或无腋窝淋巴结的乳房）进行组织病理学检查后确定最终的临床病理分期。在晚期就诊病例中，试图找出导致疾病晚期的因素。结果显示，乳腺癌主要是女性疾病，40 - 49岁相对年轻的年龄组受影响最大，占40.9%的病例，平均年龄为44.02±10.32岁。绝经前女性受影响最多，占63.6%的病例。大多数患者（62.8%的病例）在疾病晚期就诊。观察到多种因素导致疾病晚期——其中发现就诊延迟、社会经济状况差和文盲与之相关，且具有统计学意义（p<0.001）。我们的社会需要开展针对乳腺癌的大众宣传项目。应采取必要措施，向患者倡导乳房自我检查（BSE），向医疗服务提供者推广临床乳房检查（CBE）。
