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Evaluation of risk factors, diagnosis and treatment in carcinoma breast--a retrospective study.

BACKGROUND
Breast cancer is becoming more common in societies that hitherto enjoyed a low incidence of the disease. In countries like Nepal, it is one of the common malignancies in females, and its incidence is increasing with changing lifestyles, demographic and socioeconomic profiles. Ignorance on the part of the patient, lack of screening programmes and diagnostic facilities combine to increase the morbidity and mortality. This study was done to determine the risk factors, assess common modes of presentation in breast malignancies, and to evaluate treatment modalities commonly employed to manage them.


METHODS
A retrospective analysis of new cases of carcinoma breast admitted to BP Koirala Institute of Health Sciences over a period of 5 years (April 2000-February 2005) was carried out. A total of 75 cases were studied to collect data on risk factors, clinical profile and treatment. Old cases and those with inadequate documentation were excluded.


RESULTS
There were 70 females and 5 males; the mean age was 62.6 years in males and 45.7 years in females. The age at menarche ranged from 11-16 years, the mean being 13.47 years. Among the females, 45.71% were post-menopausal. History of breast carcinoma in first-degree relatives was present in 6.67% of the patients. The mean duration of symptoms before presentation was 13.6 months, most patients presenting with a painless lump. The majority of tumours were in the upper outer quadrant (36%), with 88% of patients presenting in Stage III and IV. Surgery was performed in 46 patients, 65.22% underwent Modified radical mastectomy, and chemotherapy was provided to 33 patients. Combination therapy was given to 16 patients.


CONCLUSION
Breast cancer occurred mostly in middle-aged, married, multiparous females, most of whom presented at an advanced stage. Modified radical mastectomy was the most commonly performed operation.