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Shahina Maqbool
Wednesday, June 19, 2013
Islamabad
The government has approved the establishment of a purpose-built Breast Cancer Screening Centre within the premises of the Pakistan Institute of Medical Sciences (PIMS) as part of a five-year Breast Screening Cancer Programme.
“A PC-1 of Rs225 million has been approved for the project, which is aimed at screening of generalised healthy females for early detection of breast cancer through mammography, awareness creation and behaviour change communication,” the project’s deputy director Dr. Shahina informed ‘The News’ here on Tuesday. The centre will be constructed next to the Burn Centre at PIMS, and should all go well, see completion in a year.
Dr. Shahina shared that the Breast Cancer Screening Programme was originally a national programme with an initial allocation of around Rs421 million. It was first approved by the Central Development Working Party (CDWP) back in 2006 but has been hitting bureaucratic snags ever since. However, after devolution of health under the 18th Constitutional Amendment, an ICT-specific programme has now been designed under the Ministry of Capital Administration and Development (CAD). “Bureaucratic hurdles have already delayed implementation of the project,” she bitterly remarked, hoping that the project would now have a smooth sailing.
Upon establishment, the Breast Cancer Screening Centre will offer services like history taking, and general physical examination, followed by mammography and elastography. It will be equipped with two digital mammography machines, an ultrasound machine, and a digital colour Doppler with elastography. “Between 50 to 80 women will be screened at the centre on a daily basis,” Dr. Shahina shared. It will also offer a full-time breast cancer hotline for both recorded as well as interactive counselling, and a website that provides comprehensive information on breast cancer.
While civil works continue, the project is all set to initiate mammography of up to 40 women, who visit the ante-natal OPD of PIMS. “We will not wait for the completion of the centre. Women who visit the ante-natal OPD of PIMS every day will be offered free mammography so that they do not have to pay a separate visit to the hospital for breast examination,” Dr. Shahina said. She informed that one mammography machine has already been purchased, while another will soon be added.
The significance of the centre, which will be the first facility of its kind in Pakistan, can be gauged from the fact that 1 out of every 9 women under the age of 40 in Pakistan is likely to suffer from breast cancer, as against 1 in every 22 women in India. “The goal is to achieve a reduction in prevalence, morbidity, and mortality due to breast cancer in Pakistani women on the one hand, and to increase the survival of breast cancer patients by down-staging and downsizing breast cancer through early detection, awareness and social mobilisation,” Dr. Shahina informed.
The project offers a unique opportunity for all eligible women, and not merely referred or diagnosed cases, to get their mammography done without having to undertake any out-of-pocket expenditure. Mammography, which is an X-ray examination of the breasts, generally costs between Rs3,500 to 4,000.
“Late detection of breast cancer may lead to complications requiring radiation and chemotherapy, which is painful and expensive, and may not necessarily lead to complete cure,” Dr. Shahida pointed out. Pakistan is conspicuous for late detection of breast cancer. It is often diagnosed in stages III and IV, when the disease has already spread in the bones, neck, lymph nodes, liver and lungs.
Dr. Shahina further pointed out that preventive mammography is usually unavailable to women in Pakistan. A majority of the women who undergo the test do so as referral or diagnosed cases from the Pakistan Atomic Energy Commission’s Nuclear Oncology and Radiotherapy Institute (NORI), which is the only cancer treatment facility in Islamabad, and as such, cannot cope with the increasing number of patients pouring in from across the country.
Dr. Shahina said, while there are no specific causes of breast cancer, patients with a family history of the disease are at higher risk. Advancing age, late menopause, early menarche, lack of physical activity, consumption of junk food, and hormonal factors predispose women to the risk of breast cancer.
To this end, the project will utilize the print and electronic media to raise public awareness on breast diseases, with a specific focus on breast cancer. “We will be developing health education, communication and information material and training manuals,” Dr. Shahina said. The BCC component of the project will entail printing of posters, banners and brochures; dissemination of public messages on the print and electronic media, and holding of seminars and workshops.
Source
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