Muna M. Baslaim
King Fahd General Hospital, Saudi Arabia
Muna Mohammed Ali Baslaim is currently working as Consultant Surgeon at King Fahd Hospital, Saudi Arabia. She is also the Head of the Breast Unit at King Fahd Hospital, Saudi Arabia since 2003. She has worked as Deputy Head of the Surgical Department at King Fahd Hospital for one year 2013- 2014. She has published 20 papers in reputed international journals.
Objectives: The true incidence of breast cancer in Saudi Arabia is unknown, the last reported statistics by the Saudi Cancer Registry in 2007 showed that the age standardized rate for breast cancer was 21/ 100,000; mean age of presentation was 47 years old and most of the cases present with a locally advanced disease. In our practice, physicians dealing with breast cancer patients believe that this number does not reflect the true incidence due to under-reporting of cases and poor data documentation in some centers. Method: In October 2010, we conducted a pilot screening program in Jeddah, the second largest city in the Kingdom of Saudi Arabia. A mobile unit with a digital mammography machine was used in 3 different locations in Jeddah city. Any asymptomatic Saudi woman, 40–69 years old, not pregnant nor lactating and not a breast cancer survivor was eligible. Ladies demographic data as well as risk factors were documented. This program was accompanied by awareness and educational activities at some of the ladies gathering points as well as primary health care centers. Results: The total duration of the screening program was 52 actual working days. Total number of screened ladies were 1167, out of these 154 (Recall rate 13%) required further assessments with breast ultrasound since 131 were BIRAD III, 20 were BIRAD IV and 3 were BIRAD V. After ultrasound, only 32 cases required biopsy (Biopsy rate 2.7%). Out of these, 7 cases were found to have breast cancer; 3 cases of invasive ductal carcinoma, grade II (IDC, II), 2 cases of ductal carcinoma in situ (DCIS) and 2 cases of invasive lobular carcinoma (ILC). The average age of cancer cases was 57.6 years; the average age at menarche was 12.6 years. All of them had their first pregnancy at an age ≤ 25 years old, all were multi- parous (average number of kids was 6) and breast fed their kids for an average period of 13 months. All except one used oral contraceptive pills during their life for an average period of 97 months and none of them used hormone replacement therapy. None of these cases had past history of breast disease or breast biopsy. Family history of breast cancer was positive in 3 cases and family history of other malignancies was positive in 3 cases, 2 of them were lymphoma. Conclusion: The screening program was well accepted and highly appreciated by the society. The combined work between the different sectors in ministry of health in conducting a well-structured national screening program in Saudi Arabia was fruitful and will be always needed to help discover cases at an early stage. The cancer detection rate was 0.59% which is alarming and health leaders and health workers has to be ready for this increasing load.