https://imcjms.com Ibrahim Medical College Journal of Medical Science https://imcjms.com/registration/journal_full_text/32 Tue, 02 Aug 2016 09:08:32 +0000 The aim of this study was to determine the significance of various reproductive risk factors amongst Pakistani women suffering from breast carcinoma. This observational study was carried out from March 2007 to February 2009 at three hospitals. The women who presented with breast swelling withorwithoutdischargefromnipplewereincludedinthestudy.Thediagnosisofbreastcancerwas confirmed by histopathological examination. A questionnaire included history and various reproductive risk factors. The study patients were divided into two groups by their menopausal history – pre-menopausal and post-menopausal as ‘group A’ and ‘group B’, respectively. A total of 70 patients had the diagnosis of breast cancer. Of them, 32 were in group A and 38 in group B. Regarding age distribution, 49% were found in ³51 years of age and 29% in the age group 30 – 40 years. The mean age at menarche was 13.3 years in group A and 12.4 years in group B. Nulliparity was seen in 12.5% cases in group A and 5.26% in group B. History of first full term pregnancy (FFTP) below the age of 20 was present in majority of cases in both groups though higher in group B. Breast cancer in post-menopausal women was exclusively found among those who had early menarche (<=11 years) and was more frequent among those who had FFTP below 20 years of age compared with the pre-menopausal group (88% vs. 66%). The study showed higher frequency of breast cancer in post-menopausal women having early menarche and also more frequent among those with early FFTP. Parity, breast feeding, oral contraceptive pill use were not related to breast cancer. Address for Correspondence: Dr. Masoom Raza Mirza, Associate Professor, Department of Surgery, Hamdard University Hospital (Taj Medical Complex), M. A. Jinnah Road, Karachi -74400, Pakistan. Tel: +9221327788161-2, Cell:+923218713256. E.mail:doctormasoom@yahoo.com   Breast carcinoma is also one of the commonest cancers among Pakistani women. The aim of this study was to investigate the significance of various reproductive factors amongst Pakistani women suffering from breast carcinoma. Subjects and Methods   Overall, 70 patients presented with swelling in their breast with or without discharge from nipple. Cancer was diagnosed after cytology. Of these 70 patients, 32 were in group A and 38 in group B. The mean age at menarche in group A was 13.28 years and in group B 12.42 years. The post-menopausal breast cancer was exclusively found among those who had early menarche (<=11 years). The breast cancer in postmenopausal was more frequent among those who had full term pregnancy below 20 years of age compared with the pre-menopausal group (88% vs. 66%). Family history of endometrial carcinoma was present in 2 patients from group A and 4 from group B. History of exogenous hormone intake was present in two patients in each groups. Discussion Early menarche was found significant in this study and is consistent with other findings.6 Various studies in the west have shown that nulliparity and late age at first birth increases the life time incidence of breast cancer.6,7 In contrast, this study showed no such association with parity which remains to be explained. However, FFTP below 20 years of age in relation to breast cancer of the study is found to be consistent to other studies.6,8 According to our observation early marriage and subsequent FFTP occur at an early age as compared to the western society. Other risk factors like genetic predisposition and mutant gene (BRCAI and BRCA2) could have played a role in developing breast cancer but these factors have not been addressed.6,10 Conclusion   1.   Mc Pherson K, CM Steel, JM Dixon. Breast Cancer-Epidimiology, risk factors and genetics. ABC of Breast Diseases. Clinical Review, BMJ 2000; 321(a): 624-628. 3.   Anderson WF, Matsuno RK, Shermon ME, et al. Estimating age specific breast cancer risks:a descriptive tool to identify age interactions. Cancer Causes Control 2007; 18(4): 439-47. 5.   Gangat SA, Rehman A, Ahmed MF. et al. Patterns of Aetiological and Predisposing Factors regarding carcinoma Breast. Pak Journal of Sutgery 2007; 23(1): 7-9. 7.   Jatoi I, Anderson WF, Rosenberg PS. Qualitative age interactions in breast cancer: a tale of two diseases? Am J Clin Oncol 2008; 31(5): 504-6. 9.   Pervez T, Anwar MS, Sheikh AM. Study of risk factors of carcinoma Breast in Adult female general population in Lahore. J Coll Pysicians Surg Pak 2001; 11(5): 291-3. 2026 Ibrahim Medical College. All rights reserved.