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In 2022, there were 2.3 million women diagnosed with breast cancer and 670 000 deaths globally. Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life.
Global estimates reveal striking inequities in the breast cancer burden according to human development. For instance, in countries with a very high Human Development Index (HDI), 1 in 12 women will be diagnosed with breast cancer in their lifetime and 1 in 71 women die of it.
In contrast, in countries with a low HDI; while only 1 in 27 women is diagnosed with breast cancer in their lifetime, 1 in 48 women will die from it.
Breast cancer was ranked first among Saudi females. There were 2459 female breast cancer cases. Breast cancer accounted for 17.8% of all cancers reported among Saudi nationals, and 31.4% of all cancers reported among females.
The age-Standardized Incidence Rate (ASR) was 28.4/100,000 for the Saudi female population. The five regions with the highest ASR per 100,000 population were Eastern region at 46.2/100,000, followed by Riyadh with 43.3/100,000, Qassim with 28.1/100,000, Jouf with 25.2/100,000 and Makkah region with 24.9/100,000.
Early detection and decrease mortality of breast cancer
1 Raising the rates of diagnosis and early detection cancer at an early stage of the disease.
2 Reduce incidence of breast cancer mortality.
Most people will not experience any symptoms when the cancer is still early hence the importance of early detection.
Breast cancer can have combinations of symptoms, especially when it is more advanced. Symptoms of breast cancer can include:
People with an abnormal breast lump should seek medical care, even if the lump does not hurt.
Most breast lumps are not cancer. Breast lumps that are cancerous are more likely to be successfully treated when they are small and have not spread to nearby lymph nodes.
Breast cancers may spread to other areas of the body and trigger other symptoms. Often, the most common first detectable site of spread is to the lymph nodes under the arm although it is possible to have cancer-bearing lymph nodes that cannot be felt.
Over time, cancerous cells may spread to other organs including the lungs, liver, brain and bones. Once they reach these sites, new cancer-related symptoms such as bone pain or headaches may appear.
When the patient come to the primary health center (PHC), the following procedure is performed by the PHC coordinator and Physician:
- Receive and welcomed the patient.
- Perform the nursing assessment for the clinic and register the results in the patient's health record.
- Educate about the symptoms, early signs, risk factors, prevention, and importance of early breast cancer screening.
- The PHC physician will assess the previously mentioned high risk factors for patient in the clinic by taking the medical history and performing the physical examination.
- If the patient meets the screening criteria, the physician will refer to screening mammogram through Mawead program then the woman is notified of the appointment by text message.
female population are categorized depending on their risk:
Average Risk Group: Women in the age group of 40-69 years with the following characteristics are typically considered to be at average risk for breast cancer and are eligible for regular screening mammogram (SMG):
- Not pregnant or breastfeeding
- No acute breast symptoms
- No personal or family history of breast cancer
- No current bilateral mastectomy
- Has not had SMG within the last 12 months
High Risk Group: Women in the age group of 30-69 years and fall into one of the following risk categories required referral to GS clinic or breast clinic if available:
- Previous treatment with chest radiation at a young age (between age of 10-30).
- Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing).
- Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves.
- Previously assessed by a genetic clinic (using the IBIS or BOADICEA tools) as having a ≥20 percent personal lifetime risk of breast cancer based on family history.
- 5-years risk of developing invasive breast cancer of ≥ 1.7 % in women aged ≥35 (per Gail model).
- Previous history of Breast cancer.
- Women with biopsy-proven Lobular carcinoma in situ or Atypical ductal hyperplasia.
- Strong family history:
➢ One or more of 1st or 2nd degree with:
- Breast cancer at age ≤45 years. – Ovarian cancer.
- Primary cancer of both breasts.
- Both breast and ovarian cancer in the same relative.
- Male breast cancer.
- Triple negative breast cancer diagnosed at age 60 or younger in women.
➢ Two or more first– or second-degree relatives from the same side of the family with breast cancer, if at least one breast cancer was diagnosed before age 50.
➢ Three or more of 1st or 2nd degree the same side of the family with breast, pancreatic, or prostate cancer at any age.
The breast cancer treatment options based on type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones.
· Breast cancer treatment options: breast Cancer Surgery, radiation Therapy, chemotherapy, hormone Therapy, immunotherapy, stem-cell Therapy, and supportive (Palliative) Care.
· Refer to different specialist services if needed: oncologist, reconstructive surgeon, nutritionists and dietitians, occupational therapist, physical therapist, certified lymphedema therapist, psychologist, psychiatrists, and social workers.
· Prevention: Although breast cancer cannot be prevented, the risks of developing breast cancer can be minimized through specific preventive activities. These include achieving changes in lifestyle, diet, overall physical characteristics and obesity, and interventions for women at high risk of developing breast cancer using tamoxifen and other anti-estrogen compounds.
Request screening mammogram.
Request further evaluation if needed: breast Ultrasound, breast biopsy and breast magnetic resonance imaging.
