Breast Cancer in Sabah , Malaysia : A Two Year Prospective Study

Abstract

<br/><b>Introduction</b>: Malaysian women have a 1 in 20 chance of developing breast cancer in their lifetime. Sabah,formerly known as North Borneo, is part of East Malaysia with a population of 3.39 million and more than 30ethnic groups. We conducted a 2 year prospective epidemiological study to provide unreported data of breastcancer from this part of the world and to recognise which particular group of patients are more likely to presentwith advanced disease. <br/><b>Methods</b>: All newly diagnosed breast cancers seen at the Queen Elizabeth Hospital,Kota Kinabalu, from January 2005 to December 2006 were included in the study. Patient and tumourcharacteristics, including age, race, education, socioeconomic background, parity, practice of breast feeding,hormonal medication intake, menopausal status, family history, mode of presentation, histology, grade, stage ofdisease and hormonal receptors status were collected and analysed. <br/><b>Results</b>: A total of 186 patients were seen.The commonest age group was 40 to 49 years old (32.3%). Chinese was the commonest race (30.6%) followed byKadazan-Dusun (24.2%). The commonest histology was invasive ductal carcinoma (88.4%). Stages at presentationwere Stage 0- 4.8%, Stage I- 12.9%, Stage II- 30.1%, Stage III- 36.6% and Stage IV- 15.6%. The estrogen andprogesterone receptor status was positive in 59.1% and 54.8% of cases, respectively. 73.7% of Chinese patientspresented with early cancer compared to 36.4% of the other races. Patients who presented with advanced diseasewere also poor, non-educated and from rural areas. 20.4% of patients defaulted treatment; most of them optedfor traditional alternatives. <br/><b>Conclusions</b>: Sabahan women with breast cancer present late. Great efforts areneeded to improve public awareness of breast cancer, especially among those who have higher risk of presentingwith advanced disease.