Hadi Maha Abdel, Al Ratrout Hefzi, Al Wadaani Hamid
Department of Surgery, University of Dammam Faculty of Medicine, Kingdom of Saudi Arabia.
J Breast Health. 2015 Jul 1;11(3):111-114. doi: 10.5152/tjbh.2015.2560. eCollection 2015 Jul.
The aim is to identify the ideal screening age for women in developing countries and to determine the suitable method for early detection of breast cancer based on age and readiness of the community.
A 30-year retrospective review (from 1984 to 2014) was undertaken at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Medical records of those diagnosed with breast cancer from the outpatient department and hospital admission records were reviewed, focusing mainly on demographic data, age, and time at presentation. Radiological and histopathological records were also reviewed for confirmation of diagnosis. Age-based statistical review was undertaken of the female population within the hospital catchment area.
The total number of patients was 1.832, accounting for 0.8 % affected patients when plotted against the 235,339 females within the catchment area. Considering the standard screening age of 40 years, patients were divided into two groups: group I included those below the age of 40 years at the time of diagnosis, accounting for 641patients (35%), and group II included those above the age of 40 years, accounting for 1191 patients (65%). Group I patients were mostly reassured in primary healthcare centers, diagnostic modalities were used with reservation, relying solely on ultrasonography 276 (43%); whereas in group II patients, mammography was used liberally, which aided in the diagnosis in all 1191 (100%).
Despite the undisputable notion that breast cancer has higher predilection for women above the age of 40 years, there is a substantial subset of affected younger women in developing countries, which contradicts this concept. However, the scarcity of structured sessions in developing countries dictates Western-based early detection strategies, but the validity of such programs is culture-governed. Rigorously tailored screening programs directed towards individual communities are mandatory. Reducing the screening age by a decade in developing countries may increase the capture of early breast cancer and improve the outcomes.
旨在确定发展中国家女性的理想筛查年龄，并根据社区的年龄和准备情况确定早期发现乳腺癌的合适方法。
在沙特阿拉伯胡拜尔法赫德国王大学医院进行了一项为期30年的回顾性研究（从1984年至2014年）。对门诊诊断为乳腺癌的患者的病历以及医院入院记录进行了审查，主要关注人口统计学数据、年龄和就诊时间。还审查了放射学和组织病理学记录以确诊。对医院服务区域内的女性人群进行了基于年龄的统计分析。
患者总数为1832例，与服务区域内的235339名女性相比，占受影响患者的0.8%。按照40岁的标准筛查年龄，患者被分为两组：第一组包括诊断时年龄在40岁以下的患者，共641例（35%），第二组包括年龄在40岁以上的患者，共1191例（65%）。第一组患者大多在初级医疗保健中心得到安慰，诊断方式使用谨慎，仅依靠超声检查的有276例（43%）；而在第二组患者中，乳房X线摄影术被广泛使用，在所有1191例患者中均有助于诊断（100%）。
尽管乳腺癌在40岁以上女性中更易发生这一观点无可争议，但发展中国家仍有相当一部分受影响的年轻女性，这与该观念相矛盾。然而，发展中国家缺乏结构化的筛查项目，这决定了采用基于西方的早期检测策略，但此类项目的有效性受文化制约。针对个别社区严格定制筛查项目是必要的。在发展中国家将筛查年龄降低十年可能会增加早期乳腺癌的检出率并改善治疗效果。
