Patterns of Care of Breast Cancer Patients in a Rural Cancer Center in Western India
- 32 Downloads
Breast cancer is an emerging public health problem in low- and middle-income countries. The main objective is to describe the clinical characteristics and patterns of care of breast cancer patients diagnosed and treated in a rural cancer hospital in Barshi, Western India. The results from a cross-sectional study of 99 consecutive breast cancer patients diagnosed and treated between February 2012 and November 2014 in Nargis Dutt Memorial Cancer Hospital is reported. The case records of the patients were scrutinized and reviewed to abstract data on their clinical characteristics, diagnostic, and treatment details. The mean age at diagnosis of the patients was 52.8 ± 11.6 years; 83.5% of women were married, and 60.6% were illiterate. Sixty percent of patients had tumors measuring 5 cm or less. Almost half of the patients (46.4%) had stage I or II A disease and a third (36.0%) had axillary lymph node metastasis. Estrogen, progesterone, and human epidermal growth factor receptor2 receptor status were investigated in 41 (41.4%) of patients only. The median interval between diagnosis and initiation of treatment was 11 days. Modified radical mastectomy was done in 91% of patients, and nearly a third of patients who were prescribed chemotherapy did not complete treatment. The rural-based tertiary cancer care center has made treatment more accessible to breast cancer patients and has reduced the interval between diagnosis and treatment initiation. However, there are still many challenges like non-compliance to and incomplete treatments and poor follow-up that need to be addressed.
KeywordsBreast cancer Patterns of care India Rural
Authors acknowledge patients who contributed to this study, Katkar SV, for interviewing and abstracting data from records and Badave AG and Lakashetti SS for entering data.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al (2013) GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase No. 11 [Internet}. International Agency for Research on Cancer, LyonGoogle Scholar
- 8.Indian Council of Medical Research (2001) National Cancer Registry Programme. Consolidated report of the population based cancer registries 1990-96. Incidence and Distribution of Cancer. Indian Council of Medical Research, New DelhiGoogle Scholar
- 13.Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, Mandelblatt JS, Yakovlev AY, Habbema JD, Feuer EJ, Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792CrossRefPubMedGoogle Scholar
- 19.Sobin LH, Gospodarowicz MK (2009) TNM Classification of malignant tumours. International Union Against Cancer, GenevaGoogle Scholar
- 24.Das D, Pathak M (2012) The growing rural-urban disparity in India: some issues. Int J Adv Res Technol 1:145–151Google Scholar
- 34.Donkor A, Lathlean J, Wiafe S, Vanderpuye V, Fenlon D, Yarney J et al (2015) Factors contributing to late presentation of breast cancer in Africa: a systematic literature review. Arch Med 8:1–10Google Scholar
- 39.Francis GD, Dimech M, Giles L, Hopkins A (2007) Frequency and reliability of oestrogen receptor, progesterone receptor and HER2 in breast carcinoma determined by immunohistochemistry in Australasia: results of the RCPA Quality Assurance Program. J Clin Pathol 60:1277–1283CrossRefPubMedPubMedCentralGoogle Scholar
- 40.Rhodes A, Jasani B, Balaton AJ, Barnes DM, Miller KD (2000) Frequency of oestrogen and progesterone receptor positivity by immunohistochemical analysis in 7016 breast carcinomas: correlation with patient age, assay sensitivity, threshold value, and mammographic screening. J Clin Pathol 53:688–696CrossRefPubMedPubMedCentralGoogle Scholar
- 48.Aggarwal V, Agarwal G, Lal P, Krishnani N, Mishra A, Verma AK, Mishra SK (2008) Feasibility study of safe breast conservation in large and locally advanced cancers with use of radiopaque markers to mark pre-neoadjuvant chemotherapy tumor margins. World J Surg 32:2562–2569CrossRefPubMedGoogle Scholar