Raza Uzma, Khanam Aziza, Furqan Mohammad
Department of Biochemistry, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2011 Jan-Mar;23(1):9-14.
Breast carcinoma is an unpredictable disease in the sense that some patients may die at early disease stage due to wide-spread metastasis within six months to one year, while others may survive longer. This study was aimed to evaluate the risk factors for breast carcinoma occurrence and histopathological features of breast carcinoma developed in the social and economical conditions of Pakistan.
A total of 224 female breast cancer diagnosed patients with uncovered medical insurance visiting at the Oncology clinic of a teaching hospital at Karachi, Pakistan were selected for the study. Two hundred and twenty-four (224) healthy female subjects free of any cancer diagnosis were selected as control from different areas of the city. Information on stress, occupation, life history, and life style was obtained through personal interviews. Breast tumour pathology was evaluated for histological grade, lymph node metastasis and hormone receptor status by using standard methods. Student's t-test, Chi-square test and ANOVA were used for comparison.
Breast cancer patients in significantly high percentage reported early marriages, abortion occurrence, stressful life style, family cancer history and past disease suffering from diabetes and hypertension. Life style including aerosol chewing and fat rich food intake was significantly high among the patients (p<0.05). On histopathological analysis, patients at the age of 40 years and below were identified in significantly high percentage with tumour grade III, 1-3 lymph node metastasis and hormone receptor negative type. Increasing age was associated with low tumour grade and less percentage of lymph node metastasis. Significantly high percentage of patients were presented with hormone receptor positive tumour (p<0.05).
The contributing factors for breast carcinoma occurrence were related to life history and life-style of the patients. Medical insurance uncovered patients at initial diagnosis were presented in significantly high percentage with advanced disease including high tumour grade and lymph node metastasis due to less use of preventive and screening service which delays the diagnosis, effecting both survival and treatment cost.
乳腺癌是一种不可预测的疾病，因为一些患者可能在疾病早期阶段因在六个月至一年内发生广泛转移而死亡，而另一些患者可能存活更长时间。本研究旨在评估在巴基斯坦的社会和经济条件下发生乳腺癌的风险因素以及所患乳腺癌的组织病理学特征。
选取了巴基斯坦卡拉奇一家教学医院肿瘤门诊的224名未参保的女性乳腺癌确诊患者进行研究。从该市不同地区选取了224名未患任何癌症的健康女性作为对照。通过个人访谈获取有关压力、职业、生活史和生活方式的信息。采用标准方法评估乳腺肿瘤病理的组织学分级、淋巴结转移和激素受体状态。使用学生t检验、卡方检验和方差分析进行比较。
乳腺癌患者中，报告早婚、有流产史、生活方式有压力、有家族癌症史以及既往患有糖尿病和高血压的比例显著较高。患者中包括嚼槟榔和气态烟雾摄入以及高脂肪食物摄入在内的生活方式比例显著较高（p<0.05）。组织病理学分析显示，40岁及以下的患者中，肿瘤分级为III级、有1 - 3个淋巴结转移且激素受体阴性类型的比例显著较高。年龄增长与肿瘤分级较低和淋巴结转移比例较低相关。激素受体阳性肿瘤患者的比例显著较高（p<0.05）。
乳腺癌发生的影响因素与患者的生活史和生活方式有关。初次诊断时未参保的患者中，因较少使用预防和筛查服务而导致诊断延迟，从而出现包括高肿瘤分级和淋巴结转移在内的晚期疾病的比例显著较高，这对生存和治疗费用均有影响。
