September 28, 2021, 6:55 am

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Bridge the gap: Curse of breast cancer and awareness. —— Dr. Faruquzzaman

One of the most leading causes of cancer mortality worldwide. The magnitude of this catastrophe is much severe here in our country. Most of the reliable data of national and international researches suggest that one in every 8 women is affected by this curse in her lifetime.
According to the statistics of “American Cancer Society-2020”, one in every 12 women is affected in a country like USA. And the overall mortality rate is approximately 50000 per year in USA. So far we have less authentic data regarding the exact scenario in our country. However, it is easily imaginable that the severity is more horrible here.

Description of the disease:
Breast cancer is an eminently curable disease, only if it is detected at an early stage. Let me clarify the issue of early stage. Like all other cancer, breast cancer also has four oncological stages. In first and second stage, the disease is completely curable by surgery, as the disease is relatively localized to breast and axillary lymph nodes at a limited extent.

Based upon the histopathology report of resected specimen of breast, postoperative adjuvant therapy (chemotherapy, radiotherapy, hormone therapy) may be required. Most often, at third stage disease may extent to the chest wall, muscles or overlying skin without any apparent organic metastasis. Therefore, neoadjuvant therapy (chemotherapy, radiotherapy, hormone therapy, radiotherapy) may be required to downstage the disease.

That’s why in many circumstances, curative surgery is still possible after down-staged by neoadjuvant therapy. But at stage four, the disease is completely incurable, as there is organic metastasis (cancer already spreads to different organ like lung, liver, brain or bone through blood vessels).

Cure is not possible here, the only aim of treatment is then to palliate the symptoms and to improve the quality of life of that particular dying person for a very short period. Eventually death is the inevitable result. Generally we refer the stage one and two as the early stage of carcinoma of breast, where curative treatment and complete recovery is possible. Therefore, early diagnosis and appropriate treatment on time is the only key to the satisfactory outcome.

Why this awareness for?
As mentioned earlier early diagnosis is the crucial part of management here. We have different effective tools for this purpose, quite available in different parts of our health care system in Bangladesh. But where is the problem? Lack of awareness, late presentation, social prejudice, financial drawback etc. most often unfortunately slows down the process of early referral of patients, and leads to a fatal but completely preventable outcome.

We saw Halima Begum to die. We saw Soburunessa to die. We saw Hafiza Khatun to die. We saw too many deaths in last few years in Khulna Medical College Hospital from this curse. We saw thousands of families to tear apart. But fact is that these situations were quite preventable on time in many cases.

Our message:
1. Breast cancer is a complete curable disease at early stage. Time is of essence here.
2. Diagnostic and other facilities are fully available at a very low cost at most of the different levels of government hospitals in Bangladesh including the Medical College Hospitals.
3. Moreover, provision of surgery and adjuvant therapy is also available in full range in these institutes. And the total cost of treatment is most often very low in government hospitals.
4. “Your belief, your awareness only can save you from this fatal curse”.

Dr. Faruquzzaman
FCPS, MS, MRCS, MCPS
General & Laparoscopic Surgeon
Department of Surgery
Khulna Medical College Hospital

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