Cancer esophagus Karachi 1995-2002: epidemiology, risk factors and trends

To study the trends of cancer esophagus in Karachi South during 1995-2002 and identify risk factors. Incident esophageal cancer cases recorded at the Karachi Cancer Registry for Karachi South, during 1st January 1995 to 31st December 2003 were reviewed. For maximum completion of data, incident cases registered from 1st January 1995 to 31st December 2002 were included for final analyses. The Age Standardized Incidence Rates [ASIRs] of cancer esophagus in Karachi South for males were 6.5/100,000 [1995-1997] and 6.4/100,000 [1998-2002]. In females the observed rates were 7.0/100,000 [1995-1997] and 8.6/100,000 [1998-2002]. In the moderately high incidence, cancer esophagus zone of Karachi, the ASIRs in males remained stable during the last decade, but in females, an upward trend was observed suggesting a progressively higher exposure to risk factors in the latter. The potential risk factors in Karachi are use of all forms of tobacco, areca nut, infrequent consumption of raw fruits and vegetables and diet deficiencies. There is a necessity to actively control the proven risk factors and address the existence of other risk factors. The primary recommended strategy for the control of cancer esophagus would therefore be legislation against tobacco and areca nut in Pakistan and public health education. The risk factors of cancer esophagus identified in this article need to be further confirmed

Breast diseases: a histopathological analysis of 3279 cases at a tertiary care center in Pakistan

To know the frequency of breast diseases in Pakistani females. A retrospective analysis of 3279 breast specimens received over a period of 4 years [1993-1996] at the department of pathology, the Aga Khan University Hospital. Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of them showed 3 or >3 positive lymph nodes. Grade I tumours were 11.38%, grade II 59.17% and grade III tumours 29.47%. Correlation of grade with lymph node metastases [3 or >3+ve nodes] showed 15 cases [1.53%] of grade I, 178 cases [18.25%] of grade II and 68[6.97%] cases of grade III tumours. This study shows that in Pakistani females, the most commonly encountered lesion in carcinoma of the breast followed by the benign lesions such as fibro adenoma, fibrocystic disease and others. Breast carcinoma occurs at a younger age group with predominance of high-grade lesions and with frequent lymph node metastasis

Male breast cancer

To review cases of male breast cancer. Histopathology Section, Department of Pathology, The Aga Khan University, Karachi. Fifty one cases of male breast cancer specimens, received during a period of 10 years, routinely processed and stained with Haematoxylin and Eosin were analyzed. Special stains and Immunohistochemistry were used in difficult cases. Male breast cancer affected individuals in the sixth and seventh decades of life with a mean age of 56.2 years. Infiltrating ductal carcinoma [IDC] was the predominant type. Skin involvement was seen in 27.45% of the cases. Breast lump was the most common presenting symptom followed by skin ulceration. At the time of presentation 43.13% patients had a tumour size of more than 3 cm. Male breast cancer is a rare disease. Most of our findings correspond to the published local and international data