Breast Cancer Audit in Sarawak General Hospital, A

Breast Cancer Audit in Sarawak General Hospital, A 8-Year Review
L Wong, K S Chai, J Rokayah, SH Ashrina N A Nik Azim
Poster
No: 160
Sarawak General Hospital, Kuching, Malaysia
OBJECTIVE
Breast cancer is a major cause of death worldwide and locally. It is also the most common cancer in women. The National
Cancer Registry (NCR) 2003-2005 reported an age-standardised rate (ASR) of 47.3 per 100 000. The incidence is highest in
Chinese (59.9 per 100 000) followed by Indians (54.2 per 100 000) and Malays (34.9 per 100 000)1. Malaysian women have
poor survival rates from breast cancer and it is estimated that half of the deaths from breast cancer could be prevented2.
Malaysian women have poor knowledge of the risk factors, symptoms and methods for early detection of breast cancer,
leading to late presentation2. There is still a relative scarcity of data on breast cancer in the Sarawakian population, hence
the creation of our audit.
Patient by Race
Malay
Chinese
Indian
Dayak
Others
Non-citizen
Patient by Stages on Presentation
METHODS
Breast cancer cases detected in Sarawak General Hospital were collected from July 2007 to June 2015. Demographics,
history, clinical, operative and histopathological data were collected.
RESULTS
We evaluated 764 patients with ages ranging from 17 – 91-year-old and a peak age group of 41 – 55-year-old. Malay women
make up of 36.1% of our patients while Chinese women make up 36.9% of our patients.Although the majority of Sarawak
population is Dayak, their women made up less than a quarter of our patients (23.4%).
92.9% of our patients presented with a lump, other patients presented with pain, discharge, skin changes, bone pain,
breast enlargement and nipple changes. Only 16% of patients present within a month.
Only 2 % of patients presented with early breast cancer. 14 % of patients presented at stage 1 of disease, 48% of our
patients presented at stage 2 of disease. 15% of our patient presented at stage 3 disease. 21% of patients presented with
metastatic disease.
About 74.7% of patients opted for non conserving surgery whilst only 17.9% of patients opted for breast conserving surgery.
Less than 1 % of patients underwent reconstructive surgery.
CONCLUSION
Despite yearly screening programs and public outreach programs3, many patients are still unaware that early breast cancer
is a curable disease. Public understanding should be enhanced to encourage patients to present early in their disease.
Stage 0
Stage 3
Stage 1
Stage 4
Stage 2
References
1. Yip C, Bhoo Pathy N, Teo S. A Review of Breast Cancer Research in
Malaysia. Medical Journal of Malaysia. 2014;69(Supplementary A).
2. Support group creating awareness of breast cancer [Internet].
BorneoPost Online | Borneo , Malaysia, Sarawak Daily News. 2015 [cited 1
May 2016]. Available from: http://www.theborneopost.com/2015/09/30/
support-group-creating-awareness-of-breast-cancer/
3. Lim GHalimah Y. Cancer Incidence in Peninsular Malaysia 2003-2005.
Kuala Lumpur; 2008.