Author(s): Janardana Rao Venkata Kakulapati, Shyam Prasad Pigilam
BACKGROUND Breast cancer distribution differs by geography, regional lifestyle, racial or ethnic background. In general, both breast cancer incidence and mortality are relatively lower among the female populations of Asia and Africa, relatively underdeveloped nations, and nations that have not changed to the westernised reproductive and dietary patterns. In contrast, European and North American women from heavily industrialised or westernised countries have a substantially higher incidence of breast cancer. The aim of the study is to- 1. Analyse the relationship between socioeconomic and educational status and early diagnosis of CA breast. 2. Emphasise the need for early detection of breast cancer. MATERIALS AND METHODS This study was carried out in 150 patients who were admitted in the Department of General Surgery. Inclusion criteria for patients in this study consist of patient of any age presenting with the lesion suspected of breast carcinoma and proved by FNAC and Tru-cut biopsy and all relevant investigations to stage the disease like chest x-ray, ultrasound abdomen, liver function test, mammography and skeletal survey done for advanced cases to rule out metastasis. Patients excluded where those who presented with symptoms of breast on clinical examination, but on investigation, there was no malignant pathology of breast and male patients with breast carcinoma excluded. Patients data was collected in standardised pro forma, which included age, socioeconomic status, level of education, duration of symptoms, detection of lump by the patient or medical practitioner into three class lower, middle and upper. The socioeconomic status defined by Kuppuswamy scale was used in this study. Literacy status classified into illiterate and educated, which is further classified into primary (I-IV), secondary (high school and higher secondary) and higher education (graduate and above). RESULTS In our study, among 150 patients, 34% presented in early stage. Among the patients who presented in early stage, 15.2% belonged to illiterate, 62.5% belonged to patients educated up to primary level and 70% of patients educated up to secondary level. In 150 patients, 30.7% of low socioeconomic status and 80% of patients belonging to middle class presented in early stage (stage I and II) and remaining 69.3% of low socioeconomic status and 20% belonging to middle class presented in late stage (stage III and IV). CONCLUSION Majority of the patients belonging to low socioeconomic and illiterate group presented in advanced stage of breast cancer due to patient’s negligence and lack of awareness about breast cancer. Delayed presentation of female breast cancer has a strong and significant attribution to patient delay, which will definitely have a worse impact on stage of breast cancer. Hence, targeted plans to increase breast cancer screening and treatment coverage in patients with lower socioeconomic status could reduce much of socioeconomic disparity in breast cancer diagnosis and treatment. National healthcare programmes should be launched for public awareness and early detection of breast cancer.