Retrospective analysis of breast cancer subtypes, risk factors, and lump features: outcomes from a tertiary care hospital in Multan, Pakistan
DOI:
https://doi.org/10.18203/2320-6012.ijrms20250731Keywords:
Breast cancer, Retrospective study, Risk factors, PakistanAbstract
Background: Breast cancer is the most frequently diagnosed malignancy and a leading cause of cancer-related mortality among Pakistani women. Despite its high prevalence, patients in Pakistan are often diagnosed at advanced stages, resulting in poor prognosis. This study aimed to assess the frequency of different breast cancer subtypes, clinical features, staging, grading, and receptor statuses among patients in southern Punjab.
Methods: A retrospective analysis was conducted at Nishtar Cancer Center, Multan, from October 2024 to February 2025, using medical records of 193 female patients diagnosed with breast tumors in 2024. Demographic details, risk factors, tumor characteristics, and receptor status were analyzed using statistical package for the social sciences (SPSS) version 26.0.
Results: Most patients (47.2%) were aged 40–60 years, with 96.9% being married and 17.6% having a history of breastfeeding. Most tumors were invasive ductal carcinoma (90.7%), commonly located in the upper outer quadrant (69.4%). Advanced-stage disease was prevalent, with T4 tumors (38.3%) and N1 lymph node involvement (43.5%). Grade III tumors were frequent (60.1%), and receptor analysis showed luminal B (31.6%) as the most common subtype, followed by luminal A (30.1%) and triple-negative (25.4%).
Conclusions: The findings highlight the late-stage diagnosis and aggressive nature of breast cancer in this region, emphasizing the urgent need for enhanced awareness, early screening programs, and improved healthcare accessibility to facilitate early detection and better treatment outcomes.
Metrics
References
Sarwar MR, Saqib A. Cancer prevalence, incidence and mortality rates in Pakistan in 2012. Cogent Med. 2017;4(1):1288773. DOI: https://doi.org/10.1080/2331205X.2017.1288773
Badar F, Faruqui ZS, Uddin N, Trevan EA. Management of breast lesions by breast physicians in a heavily populated South asian developing country. Asian Pac J Cancer Prev. 2011;12(3):827-32.
Huang N, Chen L, He J, Nguyen QD. The Efficacy of Clinical Breast Exams and Breast Self-Exams in Detecting Malignancy or Positive Ultrasound Findings. Cureus. 2022;14(2):e22464. DOI: https://doi.org/10.7759/cureus.22464
Gilani GM, Kamal S. Risk factors for breast cancer in Pakistani women aged less than 45 years. Ann Hum Biol. 2004;31(4):398-407. DOI: https://doi.org/10.1080/0301446042000226763
Feng Y, Spezia M, Huang S, Yuan C, Zeng Z, Zhang L, et al. Breast cancer development and progression: Risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. Genes Dis. 2018;5(2):77-106. DOI: https://doi.org/10.1016/j.gendis.2018.05.001
Gray JM, Rasanayagam S, Engel C, Rizzo J. State of the evidence 2017: an update on the connection between breast cancer and the environment. Environmental Health. 2017;16(1):94. DOI: https://doi.org/10.1186/s12940-017-0287-4
Asif HM, Sultana S, Akhtar N, Rehman JU, Rehman RU. Prevalence, risk factors and disease knowledge of breast cancer in Pakistan. Asian Pac J Cancer Prev. 2014;15(11):4411-6. DOI: https://doi.org/10.7314/APJCP.2014.15.11.4411
Saslow D, Hannan J, Osuch J, Alciati MH, Baines C, Barton M, et al. Clinical breast examination: practical recommendations for optimizing performance and reporting. CA Cancer J Clin. 2004;54(6):327-44. DOI: https://doi.org/10.3322/canjclin.54.6.327
Sørlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A. 2001;98(19):10869-74. DOI: https://doi.org/10.1073/pnas.191367098
Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A. 2003;100(14):8418-23. DOI: https://doi.org/10.1073/pnas.0932692100
Genestie C, Zafrani B, Asselain B, Fourquet A, Rozan S, Validire P, et al. Comparison of the prognostic value of Scarff-Bloom-Richardson and Nottingham histological grades in a series of 825 cases of breast cancer: major importance of the mitotic count as a component of both grading systems. Anticancer Res. 1998;18(1B):571-6.
Pangotra D, Aithmia D, Atri D. Cytomorphological spectrum of various breast lumps using FNAC as diagnostic modality. Int J Clin Diagnost Pathol. 2022;5:05-11. DOI: https://doi.org/10.33545/pathol.2022.v5.i3a.471
Saadaat R, Abdul-Ghafar J, Haidary AM, Rahmani S, Atta N. Age distribution and types of breast lesions among Afghan women diagnosed by fine needle aspiration cytology (FNAC) at a tertiary care centre in Afghanistan: a descriptive cross-sectional study. BMJ Open. 2020;10(9):e037513. DOI: https://doi.org/10.1136/bmjopen-2020-037513
Ng CWQ, Lim JNW, Liu J, Hartman M. Presentation of breast cancer, help seeking behaviour and experience of patients in their cancer journey in Singapore: a qualitative study. BMC Cancer. 2020;20(1):1080. DOI: https://doi.org/10.1186/s12885-020-07585-8
Siddiqui R, Mehmood MH, Khan NA. An overview of breast cancer in Pakistan. Discover Med. 2024;1(1):82. DOI: https://doi.org/10.1007/s44337-024-00089-5
Kumar S, Shaikh A, Rashid Y, Masood N, Mohammed A, Malik U, et al. Presenting features, treatment patterns and outcomes of patients with breast cancer in Pakistan: Experience at a university hospital. Indian J Cancer. 2016;53(2):230-4. DOI: https://doi.org/10.4103/0019-509X.197728
Abraham M, Lak MA, Gurz D, Nolasco FOM, Kondraju PK, Iqbal J. A Narrative Review of Breastfeeding and Its Correlation With Breast Cancer: Current Understanding and Outcomes. Cureus. 2023;15(8):e44081. DOI: https://doi.org/10.7759/cureus.44081
Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers (Basel). 2021;13(17). DOI: https://doi.org/10.3390/cancers13174287
Chan S, Chen J-H, Li S, Chang R, Yeh D-C, Chang R-F, et al. Evaluation of the association between quantitative mammographic density and breast cancer occurred in different quadrants. BMC Cancer. 2017;17(1):274. DOI: https://doi.org/10.1186/s12885-017-3270-0
Park SY, Park JY, Park JW, Kim WH, Park JY, Kim HJ. Unexpected hyperechoic lesions of the breast and their correlations with pathology: a pictorial essay. Ultrasonography. 2022;41(3):597-609. DOI: https://doi.org/10.14366/usg.21243
Giammarile F, Vidal-Sicart S, Paez D, Pellet O, Enrique E-L, Mikhail-Lette M, et al. Sentinel Lymph Node Methods in Breast Cancer. Semin Nuclear Med. 2022;52(5):551-60. DOI: https://doi.org/10.1053/j.semnuclmed.2022.01.006
Mohammed AA. The clinical behavior of different molecular subtypes of breast cancer. Cancer Treatment Res Communic. 2021;29:100469. DOI: https://doi.org/10.1016/j.ctarc.2021.100469
Irigoyen M, García FV, Iturriagagoitia AC, Beroiz BI, Martínez MS, editors. Molecular subtypes of breast cancer: prognostic implications and clinical and immunohistochemical characteristics. Anales Sis San Navarra. 2011;34(2):219-33. DOI: https://doi.org/10.4321/S1137-66272011000200008
Oluogun WA, Adedokun KA, Oyenike MA, Adeyeba OA. Histological classification, grading, staging, and prognostic indexing of female breast cancer in an African population: A 10-year retrospective study. Int J Health Sci (Qassim). 2019;13(4):3-9.