Early Detection of Breast Cancer among Females at Fakous District, Sharqia Governorate, Egypt

Background: Breast cancer is the most important cancer with women in an increasing numbers in incidence developing countries. It is by far the commonest cancer among Egyptian women and represents 37% of all female cancers. Objectives: Early detection of breast cancer and determining the most frequent barriers of delay in breast cancer diagnosis among females at Fakous district Sharqia Governorate in addition to identification of the risk factors and prevalence of breast cancer in the year 2010. Subjects & Methods: Community based survey study at Fakous district Sharqia Governorate for 6 months period (from 1 January 2010 -to 30 June 2010). A multistage cluster random sampling was adopted for this work on a sample of 390 females. The study tools included:a- a questionnaire which was designed and pretested in pilot testing before the study. It was prepared to ask women about some socio-demographic characteristics and risk factors of breast cancer. In addition to any suspected symptoms of breast cancer as lump pain or tenderness or nipple discharge. b-Weight and height were measured to calculate Body mass index (BMI). c-Clinical Breast examination. d-Referral of the suspected cases to Fakous Cancer Center for doing mammogram ultrasound and fine needle biopsy to ensure the diagnosis. Results: The most frequent interviewed age groups were 30-39 ys 20-29 ys and 40-49 years (27.9% 24.4% and 22.1% respectively) with mean age (38.7) years and median age 36.5 years. About 52% of the studied females had early menarche ( st full term pregnancy (at =35years) represented more than one quarter (26.6%) of the studied females and no breast feeding which constituted 59% among the multipara women. More than 54% of the studied sample was overweight and obese with positive family history of breast cancer constituted 3.5%. About 86.7% of the menopausal women had delayed menopause (=50 years). Illiteracy took the upper hand among the studied females (34.6%). 23.1% of the studied sample was oral contraceptive users. After doing clinical breast examination (CBE) of women and mammography; 23 cases were presented by breast lesions (5.9%). 18 cases were diagnosed as benign breast lesions (4.6%) and 5 cases were confirmed as breast cancer BC (1.3%) by ultrasonography & fine needle aspiration biopsy. Histopathological reports for the discovered BC cases revealed that 2 females presented with infiltrating duct carcinoma (IDC) and 2 cases presented with ILC 3 cases (60%) had lymph node metastasis. Mean tumor size was 3.9 cm. By reviewing the BC stages among the females with breast cancer it was found that 2 cases were in stage II (40%) 2 cases were in stage III (40%). It was found that lack of doing mammography annual CBE & monthly BSE were the main limitations for early diagnosis of breast cancer. In addition to illiteracy reluctance in seeking medical care far distance from health services negligence of the complaint and fear from BC diagnosis constituted the most frequent barriers for early detection of breast cancer among the studied females. Recommendations: taking any womens breast complaints seriously Proper training programs for women about monthly breast self examination for early detection of any breast lesion. Health education programs on a wide scale on the studied places to improve not only awareness or knowledge but also changing the faulty attitudes & practices about breast cancer especially among illiterate women. In addition to training programs for health care providers at primary health care units about the importance of annual CBE in early detection of BC cases especially in low resources settings.