The number of breast cancer patients in Chattogram has increased by 43% in the last four years. Most of them are young and from lower to middle-income families, according to the data of Chattogram Medical College Hospital (CMCH).
According to the data, the number of patients was around 6,500 in 2021 (from January to date) while 4,500 breast cancer patients visited the hospital in 2017.
The figure dropped in 2020, due to the ongoing pandemic. Around 4,600 breast cancer patients visited CMCH in 2020, some 5,500 patients in 2019 and some 4,900 patients in 2018.
Among the cases, most are suffering from inflammatory breast cancer, which spreads very quickly in the body, CMCH doctors also found.
In CMCH, most of the patients are aged 25-40 while one-fourth of them are in an advanced level, two-fourth in secondary and the rest are in early stages.
Most of the patients died early due to their socio-economic status, inadequate medicines, beds and inoperative equipment, doctors said.
The number of breast cancer patients in the hospital are increasing rapidly due to lack of proper knowledge and awareness, failure in check-ups and religious barriers, said Oncologist Dr Ali Asgar Chowdhury.
The average woman's reproductive years are between ages 25 to 40 but most of them are fighting breast cancer, he said, adding that once the cancer was called "rich people's disease". Now more patients are from lower to middle-income families.
Dr Ali Asgar, also an assistant professor of the Department of Oncology at CMCH, said a good number of breast cancer patients come from the Cox's Bazar district. Due to having no community-based data, an authentic figure is yet to be identified.
The figure might be larger as some patients are receiving treatment from private hospitals and some are going to Dhaka or outside the country and remain out of the list, doctors say.
Some women visit gynaecologists as they are comfortable with female doctors. Among them, most patients are diagnosed with inflammatory breast cancer (IBC), a rare and aggressive form of breast cancer. In the IBC, instead of forming a lump, the affected breast becomes swollen red and tender, often in a matter of days or weeks.
Women who come with a lump are mostly diagnosed with cancer and due to lack of awareness, they have to go through more health hazards, said Munawar Sultana Lina, a gynaecologist in Chattogram.
It should be mandatory for women every month to be screened through self-examination or by a nurse, especially in all educational institutions and offices like garments factories, said Lina, who is also an assistant professor of CMCH.
According to Globocan data, breast cancer is the leading dreadful cancer for women in Bangladesh. In 2020, a total of 13,028 women were diagnosed with breast cancer and 6,783 died. The figure of 5-year prevalence (all ages) is 31,232.
After 2015, breast cancer was positioned first in the cancer list while before this year cervical cancer was considered first.
Due to the lack of population-based cancer registers, national cancer control programmes and organisation-based screening programmes, Bangladesh has no authentic data of cancer patients and survivors.
For that, specialists emphasised national-level planning and population-based research.
Dr M Habibullah Talukder Ruskin, head of the Cancer Epidemiology Division at the National Cancer Research Institute, told The Business Standard "We have only hospital-based treatment, not community-based screening programmes."
Ruskin, who is the founder of the Bangladesh Breast Cancer Awareness Forum, suggested that Bangladesh needs to take three steps to get real data and the number of patients. Those are—population-based cancer registers for real figures, national cancer control programmes for prevention and national screening programmes for early detection.
He also said as short term programmes can only build awareness slightly, we need national level steps for decreasing the death toll from breast cancer in Bangladesh.
October is considered breast cancer awareness month. Several Non-Government Organisations (NGOs) and Medical College Hospitals organise some awareness programmes, which are few considering the total population.
In urban areas, women know about breast cancer but are not screened regularly while in rural areas, women are yet to have any awareness about cancer.
It is mandatory for all women to self-examine every week, get regular screenings and get mammograms done annually especially if they are above 40 years.
In Bangladesh, only one-fourth of patients come under the diagnosis and treatment, rest died without any screening, diagnosis or treatment.