Breast Cancer In Bangladesh Research Articles

Application of Next Generation Sequencing technology to determine breast cancer risk among Bangladeshi women

Abstract Recent advancement in sequencing technology had led to the accurate and precise diagnosis of deadly diseases like breast cancer. Breast cancer is the second most common cancer in women, therefore, early diagnosis of this critical disease is important for prevention and therapeutic implications. BRCA1and BRCA2genes are significantly associated with breast cancer aetiology. Individuals carrying a germline mutation in BRCAgenes increase their chance of developing breast or ovarian cancer in women and pancreatic cancer in both sexes. The purpose of this study was to determine the germline mutations of BRACAamong the risk group of Bangladeshi women using Next Generation Sequencing (NGS). One hundred patients were selected randomly from the outdoor breast cancer clinic of DNA Solution Ltd. Using ‘Six-Point Scale’ twenty individuals were selected for BRCAgene mutation study. A clinical database was maintained to record personal and familial cancer history of the selected individuals. Personal identification was preserved according to Helsinki principals. Out of twenty enrolled individuals, seventeen individuals had a family history of cancer. However, upon sequencing data analysis, we observed only six patients carrying the pathogenic mutation of BRCAgene. This study only involved germline mutation and did not consider somatic mutation. Recent reports also suggest various genes other than BRCAare also associated with breast cancer occurrence. To our knowledge, this is the first time to use NGS technology to screen genetic mutations of breast cancer in Bangladesh. These data will help to develop early screening and possible prevention with better disease management in breast cancer. No Funding Support

Knowledge and perception of breast cancer among women of reproductive age in Chattogram, Bangladesh: A cross-sectional survey.

Background and AimsBreast cancer is the second leading cause of cancer death in women worldwide. The significantly higher mortality rate has been considered due to poor knowledge of women, delay in diagnosis, and initiation of treatment. Therefore, this hospital‐based cross‐sectional study aimed to understand the knowledge and perception of women with breast cancer in Bangladesh.MethodsData was collected using a questionnaire‐based interview from 357 women aged 15–49 years attending two tertiary care hospitals in Chattogram city of Bangladesh.ResultsNeighbors (18.6%) and relatives (18.1%) were the leading sources of information on breast cancer. Among the total, 69.5% knew about breast cancer however, only 14% of them knew about screening tests and 61.5% were unaware of risk factors for developing breast cancer. Pain in the breast, painless lump, and nipple discharge were the most recognized clinical symptoms by the participants. Exercise and weight control, the practice of breastfeeding, and taking medicine were the three most known prevention practices. Women perceived wrong conceptions that Breast cancer is only found in older age (42.3%) and women (15.7%) and that it causes losing one's breast (3.1%). A significant correlation was found between the education level of participants and their knowledge of risk factors related to breast cancer.ConclusionAlthough the majority of the participants have heard about breast cancer, they do not possess enough knowledge regarding the risk factor, symptoms, and preventive methods of breast cancer. We suggest interventions targeting a community‐based awareness program

Abstract 2216: Impact of EXO1 (K589E) single nucleotide polymorphism on breast cancer risk in Bangladeshi women

Abstract Background and aim: Exonuclease 1 (EXO1) is an essential member of the RAD2 nuclease family which is involved in mismatch repair system and contributes to the maintenance of genomic stability, modulation of DNA recombination and cell cycle arrest mediation. Potential polymorphism in EXO1 may have the ability to control cancer risks by influencing the repair activity. K589E (rs1047840) is a potentially functional polymorphism in EXO1 gene and we hypothesized that it might be associated with risk of breast cancer in Bangladesh. Method: We designed a case-control study consisting of 184 subjects with breast cancer and 200 healthy controls to identify the effect of K589E polymorphism on breast cancer susceptibility and clinicopathological features in Bangladeshi women. Genotype determination was performed by PCR-RFLP method. Results: After the adjustment of age and weight, a significant association was found between EXO1 K589E alleles and genotypes and risk of breast cancer. The frequencies of the three genotypes G/G, G/A, and A/A were 49, 42, and 9% in cases whereas 69, 27.5, and 3.5% in controls, respectively. The heterozygote G/A genotype and combined G/A+A/A genotypes showed 2.12-fold (OR=2.12, 95% CI=1.3733 - 3.2822 p=0.0007) and 2.27-fold (OR=2.27, 95% CI=1.5001 - 3.4493, p=0.0001) increased risk of breast cancer, respectively when compared with homozygous G/G genotypes. The variant A allele also was associated with increased risk of breast cancer (OR= 3.46, 95% CI=1.3720 - 8.7571, p=0.0086). Analysis of clinicopathological characteristics and genotype distribution also showed a significant correlation. Conclusion: Our results revealed that EXO1 K589E polymorphism could be a potential predisposing risk factor in genetic susceptibility to breast cancer in Bangladesh. Citation Format: Md. Mustafizur Rahman, Md. Mahmudul Kabir, Md. Abdur Rahman, Amir Hossain, Md. Golam Hossain. Impact of EXO1 (K589E) single nucleotide polymorphism on breast cancer risk in Bangladeshi women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2216.

Age variation of incidence of breast cancer in Bangladesh: Single breast center experience

Introduction: Incidence of breast cancer is increasing worldwide, and Bangladesh is no exception. As we are yet to have a national cancer registry database, we looked at our breast unit’s patients database to look at details of age variations in breast cancer diagnosis and its implication on screening.

Sociodemographic and Reproductive Factors Associated with Breast Cancer: A Case-Control Study in a Cancer Specialized Hospital of Dhaka City, Bangladesh

Background: Breast cancer is the most common cancer in women in the world. In Bangladesh, the breast cancer is estimated to have the age-standardized incidence rate of 25.2 per 100,000 females of all ages.
 Objective: The objective of this study was to identify the sociodemographic and reproductive factors associated with the development of breast cancer in Bangladesh.
 Materials and method: A case control study was conducted on 136 female subjects, in a cancer specialized hospital of Dhaka city (68 subjects for case group with breast cancer and 68 subjects for control group without any known cancer) aged ≥20 years. Data was collected by face to face interview with structured questionnaire. The results were reported by adjusted odd ratios (ORs) and corresponded 95% confidence intervals (CIs). A p-value less than 0.05 were considered statistically significant. Independent factors associated with breast cancer were established using multivariate logistic regression analysis.
 Result: Among the reproductive factors, women with the history of hysterectomy are 84% less likely and post-menopausal women are 27.83% more likely to get breast cancer. On sociodemographic background women who received 12+ years of schooling and 6 to 10 years of education are 14.91% and 4.91% more likely to get breast cancer. Women with the monthly family income of 5000 Tk to 25000 Tk are 76% less likely to get breast cancer than women with more monthly family income. Women married for more than 20 years are 7.27% more likely to get cancer. Women with 3 or more children are 81% less likely to get breast cancer than women with fewer children.
 Conclusion: Our study suggests that, age, level of education, monthly family income, history of hysterectomy of the patient may play an important role in risk of breast cancer in Bangladeshi women. Further research is needed to better understand the complex interactions between environmental, reproductive and genetic factors.
 Delta Med Col J. Jul 2020 8(1): 4-8

YouTube as a Potential Medium for Liquid Health Communication: A Study on Women’s Consciousness Regarding Breast Cancer in Bangladesh

YouTube as a Potential Medium for Liquid Health Communication: A Study on Women’s Consciousness Regarding Breast Cancer in Bangladesh

Burden of breast cancer in Bangladesh-current and future and financing treatment with link to willingness to pay

Breast cancer is the most common cancer type among females worldwide affecting 1 in 8 women. As of 2015, breast cancer is still a leading cancer of women in Bangladesh. It has become a hidden burden which accounts for 69% death of women within the country. The rate grows up day to day due to unawareness of the people, lack of confidence about medical treatment, improper screening, maltreatment, and lack of motivation to go for institutional treatment and management. The treatment options for breast cancer are relatively very expensive. People may be willing to sacrifice overall health to channel resources towards high priority disease areas, such as cancer to improve overall life. It is highly appropriate now to link treatment fall out and finances to the patient population. This short communication adopts a descriptive approach. First, it looks at the prevalence of breast cancer in Bangladesh, how breast cancer can be managed, how treatment can be financed and willingness to pay by individuals. This article finds that the screening can be optimized as the treatment options for breast cancer are relatively very expensive in a low resourced country such as Bangladesh. Data should be disseminated among the concerned stakeholders including the women susceptible to breast cancer, the patients, the care-givers, doctors, other health-care workers and policy-makers for better management. Improving the cancer scenario overnight is not an easy task but policy makers may become interested and push this agenda forward, if the huge health impact and economic loss caused by cancer become evident to them.

Patient Delay and Stage of Diagnosis among Breast Cancer in Bangladesh

Early diagnosis and prompt treatment is the principal goal of physicians dealing with breast cancer. In breast cancer care there are several causes of delay. Delay in diagnosis may be either patient or health provider originated. Besides there are no effective surveillance system, no nationwide active campaign for early diagnosis and screening. Hence delay in diagnosis is not unlikely. The study was done in a Cross sectional setting during January to December 2009 at the Department of Oncology of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital, National Institute of Cancer Research & Hospital. A total 106 breast cancer patients were recruited for the study from the mentioned study places. Our data suggests on average 40 days delay from development of first symptom to attending traditional or unqualified provider. Time taken in transition from unqualified provider to qualified medical personnel was around another month. The time taken by medical personnel to establish the diagnosis through histopathology was around another 12.5 ±7.0 days, thereafter to perform surgery after diagnosis it took 17.8 ± 18.1 days. After surgery another 31.05±33.8 days were needed to start adjuvant chemotherapy or radiotherapy. Mean total time lapsed from appearance of symptom to perform surgery among breast cancer patients was 114.3±53.2 days with a median delay of 117.5 days. Mean total time lapsed from appearance of symptom to have chemotherapy or radiotherapy among breast cancer patients was 151.2±62.8 days with a median delay of 124 days. Regarding the cause of delay, in 53.8% cases, delay was resulted due to lack of awareness, in 38.9% cases delay was due to lack of money for treatment, in 7.5% case delay was due to the attempt to rely on alternative medicine, in 14.2% cases patients were reluctant, in 18% cases delay was due to problem in diagnosis. In 13.2% cases physician was treating the patient for other reason, in 36% cases patient herself made the delay for fear of consequences of disease or treatment and in 22% cases delay occurred due to long waiting period for surgery. In most cases delay resulted from multiple reasons. Patients with stages III & IV were found to have significantly more total delay than stage I & II diseases (p<.05). Patients with higher educated level made less delay than lower educated level. In conclusion, most important delay is caused by patient's own criteria and negligence. Awareness raising campaign may play an important role in reduction of the delay. Faridpur Med. Coll. J. 2021;16(1):12-16

Breast Cancer in Bangladesh

Abstract not available
 Journal of Surgical Sciences (2015) Vol. 19 (2) : 42-43

Prevalence of Breast Cancer at Divisional Level in Bangladesh

Background : Breast cancer remains a leading dreadful cancer of women in Bangladesh. Lack of screening program is the reason behind this high morbidity and mortality. The Government of Bangladesh (GOB) has taken initiative to develop a breast cancer screening program by Clinical Breast Examination (CBE) throughout the country. But there is almost no information on baseline prevalence of breast cancer in Bangladesh. Moreover, cancer surveillance is a fundamental element of the Cancer Control Strategy. To form a foundation of this surveillance program, the survey was done to determine the breast cancer prevalence in Chittagong Division of Bangladesh. Materials and methods: This cross-sectional population-based survey was conducted by the department of Surgery, Chattogram Medical College Hospital, in Chattogram Division from 01.12.2017 to 31.04.2018. Females willing to participate in the survey were included from 4 Upazilas (Anwara, Boalkhali, Lohagara and Patiya) of Chattogram district. CBE of the study population was performed by trained physicians to identify the suspected positive physical signs for breast carcinoma. These patients were further investigated by FNAC. Data were collected and analyzed. Results: Out of 732 women surveyed, 2 subjects (A crude prevalence rate of 273.22/100,000 women) were finally diagnosed as carcinoma breast and another 29 had benign breast disease. Conclusions: This survey is an initiative towards a large scale itra-divisional epidemiological investigation inBangladesh. The peak of breast cancer incidence in Bangladesh may be 15–20 years before the peak incidence in Western countries, suggesting that more attention should be paid to the premenopausal women.
 JCMCTA 2018 ; 29 (2) : 4-8

Clinico-Morphological Pattern of Breast Cancer at In patient Department of Dhaka Medical College Hospital – Study of 60 Cases

Background: Breast cancer incidence is increasing in Bangladesh with changing lifestyles, demographic and socioeconomic profiles. But there is no structured data on clinico-morphological pattern of breast cancer in Bangladesh. Understanding the clinical & morphological pattern of breast cancer of this country will help in early detection & prompt treatment of the cancer.Objective: To find out the clinical features of breast cancer & their morphological pattern at a tertiary level hospital.Methods: This is a cross sectional study. Data were collected prospectively from 60 new female patients with diagnosed breast carcinoma admitted to Dhaka Medical College Hospital at different surgical wards over a period of six months starting from 1st August 2010 to 28th February 2011 with the help of pre-designed semi-structured data collection form for clinical & histopathological data. Male patients, severely ill patients and patients unwilling to take part in the study were excluded. Informed written consent was taken from each case. After analysis & compilation the results were presented in tables, graphs and charts.Results: The mean age of breast cancer patients was 37.13 years. The average duration of symptoms of breast cancer patients before first presentation at tertiary level health facilities was 8.9 months. Most of the patients presented to tertiary level health facilities from 6 to 12 months after appearance of first symptom. Painless lump was the commonest presenting complaint with 43 cases, followed by nipple retraction in 24 cases, peu-de-orange in 21 cases, painful lump in 17 cases, ulceration in 12 cases and nipple discharge in 5 cases. 67% had tumor in the left breast whereas 28% had tumor in the right breast. Only 5% cases presented with bilateral involvement. The most frequent location of primary tumor was upper outer quadrant which is 32 cases followed by central in 9 cases, lower outer in 8 cases, lower inner in 6 cases, upper inner in 3 cases and overlapping lesions in 2 cases. Majority of the patient (69%) presented with a tumor size of more than 5 cm whereas only 3.3% patients presented with tumor size of less than or equal to 2 cm. Axillary lymph nodes were involved in most of the cases(86.66%). Infiltrating ductal carcinoma, NOS (which is an abbreviation for nothing otherwise specified) was the commonest (98.33%) histopathological variant. Most of the patients of this series, i.e. 35 patients had poorly differentiated tumor. 4 patients had well differentiated tumor and 21 patients had moderately differentiated tumor.Conclusion: In my study breast cancer is found to be common among relatively younger age group, majority below 40 years. The patients of breast cancer are coming to a tertiary level hospital very late, mostly with clinical features of advanced disease. For better understanding a series of multi centre studies are neededJ Shaheed Suhrawardy Med Coll, December 2015, Vol.7(2); 49-53

Risk Factors for Premenopausal Breast Cancer in Bangladesh.

Background. The incidence of premenopausal breast cancer is rising throughout South Asia. Our objective was to determine the role of risk factors associated with Westernization for premenopausal breast cancer in Bangladesh. Methods. We conducted a matched case-control study between January 1, 2007, and December 31, 2010, at four hospitals in Bangladesh. Cases were premenopausal women diagnosed with invasive breast cancer. Controls were premenopausal women with no personal history of breast cancer. Logistic regression was used to calculate the odds ratios (OR) for breast cancer. Results. We identified 129 age-matched pairs. The mean age of breast cancer diagnosis was 37.5 years. Each year decrease in the age of menarche significantly increased the risk of breast cancer (OR = 1.67, 95% CI 1.09–2.56, P = 0.02). The risk was also increased with a current body mass index of ≥25 kg/m2 (OR = 5.24, 95% CI 1.10–24.9, P = 0.04). Age at first childbirth, parity, and breastfeeding were not significantly associated with premenopausal breast cancer risk (P > 0.05). Conclusions. Age at menarche and adult weight gain were associated with premenopausal breast cancer risk. Other factors associated with Westernization may not be relevant to premenopausal breast cancer risk in Bangladesh.

Relationship of Blood Groups (ABO & Rhesus) and Breast Cancer in Bangladesh

Correction: On the website, on 16/08/2014, the first author was changed from Chulam Mostafa Khan TO Ghulam Mostafa Khan. The PDF was correct.Background: The association of blood groups with breast cancer in our country is not fully established elaborately and large scale studies have not been carried out till now. Therefore this study was designed to find out the possible relationship of different blood groups with breast cancer. Objective: To determine the relationship of various types of breast cancer with ABO and Rh blood groups among the female patients of our people.Materials and Methods: This cross sectional study was conducted in the cancer unit of Delta Medical College and Hospital, Dhaka from January 2011 to February 2013. After proper and ethical consideration total 112 female patients with breast cancer were included in this study. Various factors like age, family history, metastasis, type of cancer were considered in this study. The blood groups of the patients were done by standard ABO and Rh typing methods (Forward & Reverse grouping by test tube method).Results: Among 112 breast cancer patients of our country, ductal breast cancer was found in 108 (96.42%) subjects, distant metastasis was found in 93 (86.9%) cases and positive family history in 70 (62.50%) subjects.Conclusion: Ductal type of breast cancer with positive family history and distant metastasis is common in different blood groups in our country.DOI: http://dx.doi.org/10.3329/jemc.v4i2.19679J Enam Med Col 2014; 4(2): 106-109