Late Presentation and Management of South Asian Breast Cancer - PDF document

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/51839344 Late Presentation and Management of South Asian Breast Cancer Patients in West Yorkshire, United Kingdom Article in Asian Pacific journal of cancer prevention: APJCP · January 2011 Source: PubMed CITATIONS READS 10 70 3 authors: Sreekumar Sundara Rajan Jennifer NW Lim Leeds Teaching Hospitals NHS Trust University of Wolverhampton 7 PUBLICATIONS 145 CITATIONS 38 PUBLICATIONS 397 CITATIONS SEE PROFILE SEE PROFILE Anwar Haq Southport and Ormskirk Hospital NHS Trust 5 PUBLICATIONS 61 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: AN EXPERIENTIAL LEARNING THEORY APPROACH TO IMPROVE STUDENT LEARNING AND EXPERIENCE: A PILOT STUDY OF PLASTIC WASTE (CUPS AND BOTTLES) MANAGEMENT USING STUDENT SUSTAINABILITY CHAMPIONS IN THE INSTITUTE OF HEALTH, FEHW View project MinD: Designing for People with Dementia View project All content following this page was uploaded by Jennifer NW Lim on 28 November 2014. The user has requested enhancement of the downloaded file.

Late Presentation and Management of South Asian Breast Cancer Patients in Yorkshire, UK RESEARCH COMMUNICATION Late Presentation and Management of South Asian Breast Cancer Patients in West Yorkshire, United Kingdom Sreekumar Sundara Rajan 1 *, Jennifer NW Lim 2 , Anwar Haq 3 Abstract Background: The objective of this study was to bridge the knowledge gap and improve our understanding of the late presentation and management of breast cancer among South Asian women of non-oriental origin (SA) living in the United Kingdom. Methods: Retrospective review of the breast cancer waiting list data-base held at Calderdale and Huddersfjeld NHS trust was undertaken to identify SA women diagnosed with breast cancer from January 2000 to August 2007. Results : We identifjed 41 (2.5%) SA women among 1,630 patients diagnosed with breast cancer during this period and 36 were included (median age = 53.5 years, range= 32-84). Only 19% (n=7) were screen detected and 81% (n=29) presented thorough symptomatic breast clinic. In the latter, 66% (n=19) were in the screening age group and 45% (n= 13) presented beyond 8 weeks (late presentation). In our cohort, 91% (n=29) patients had advanced disease (TNM stage 2 and 3) resulting in a high mastectomy rate of 61% (n=22). 19% (n=7) died as a direct result of cancer and the remaining 78% (n=28) remains disease free following treatment thus far. Conclusion: The delay in presentation and poor national breast screening programme uptake among the SA women resulted in advanced disease at diagnosis. There is need for increasing the breast cancer awareness as well as encouraging breast screening among SA women in the UK. Keywords : Breast cancer - ethnicity - South Asian - patient delay - late presentation - UK Asian Pacifjc J Cancer Prev , 12 , 1615-1618 Introduction Santos et al. (2003) did not fjnd any. This may be due to the variation in the way ethnic minorities are concentrated There has been a gradual increase in the incidence around various regions in the UK, as these studies were of breast cancer among the South Asian women of non- from geographically different regions. Similarly, the oriental origin (SA) living in the United Kingdom (UK) studies collected data from the regional cancer registries (Smith et al., 2003, Jack et al., 2009). A similar trend in the late 80’s just prior to and after the introduction was seen in the pre-menopausal and peri-menopausal of National Breast Screening Programme reducing its SA women in comparison to Caucasians and African- reproducibility and generalisability. Since then, there were Americans in the recent surveillance, epidemiology and no further studies done to address the delayed presentation end result (SEER) data from the United States (USA) of breast cancer among the SA communities. The lack of (Kakarala et al., 2010). consistency and uniformity of the ethnicity data collected Late presentation with breast cancer and advanced under the National Health Service (NHS) as well as in the stage at diagnosis has been seen in SA women living in National Breast Screening Programme (NHSBSP) makes the United States (Eley et al., 1994; Hunter, 2000; Li et any policy making decisions even more challenging. al., 2003). In the United Kingdom, similar observation We conducted this retrospective study at the Calderdale was made; South Asian women tended to delay in their and Huddersfjeld NHS trust, a District General Hospital presentation for medical care (Dos Santos et al., 2003; based in West Yorkshire, UK, serving a relatively large Velikova et al., 2004; Jack et al., 2009). population of people from South Asian origin. The To date in the UK, only Dos Santos et al. (2003), aim of this study was to bridge the knowledge gap and Velikova et al. (2004) and Jack et al. (2009) evaluated improve our understanding of the late presentation and the survival data of SA women and of these, only the management of SA breast cancer patients living in the UK earlier 2 studies evaluated the mode of presentation of breast cancer among SA women. However, contrasting Materials and Methods results were reported, with Velikova et al. (2004) noticing delayed presentation among SA women, whereas Dos The Calderdale and Huddersfjeld NHS trust is a district 1 Leeds Teaching Hospitals NHS Trust, Leeds General Infjrmary, 2 Leeds Institute of Health Science, School of Medicine and Health Sciences, University of Leeds, Leeds, 3 Huddersfjeld and Calderdale NHS Trust, Huddersfjeld Royal Infjrmary, Huddersfjeld, UK *For correspondence: drsreek_79@yahoo.co.in 1615 Asian Pacifjc Journal of Cancer Prevention, Vol 12, 2011