Let’s talk about breast cancer

Published: October 13, 2011

Many women do not get breast masses checked as they are reluctant or shy. This practice kills many women every year.

I saw a patient yesterday. She was a 40-year-old mother of three, her youngest daughter only six. The patient had gone to a general surgeon because of a breast mass and she had been referred to me for diagnostic work up.

The lady told me that she’d had the mass for over a year.

I asked her why she hadn’t seen a doctor earlier, and she said that she hadn’t wanted to draw attention to herself. The family had limited resources and she did not wanted to become an additional burden.

My patient had cancer.

I suspected as much the moment I saw the mass. And when I saw the slides, my suspicions were confirmed.

The year was 1999. I was a final year medical student. We were attending the out patient clinic at Mayo Hospital in Lahore.

With our professor we saw patient after patient who had ignored a breast mass for a long time before finally giving in to the pain or weakness.

I remember one patient in particular who had come from a village near Peshawar. She had ignored her breast mass for a few months. Then she had sought the blessings of her local pir. When that didn’t work, she had gone to a hakeem who had given her a potion which had obviously not helped. More than a year after first noticing her breast mass, she had finally gone to see a local doctor, who had referred her to Mayo Hospital. By the time she made it to Lahore, the cancer had replaced all of her breast and spread to her axilla and beyond. A mass which could have been removed completely a year earlier had now become incurable.

These are sad stories. And these stories are not at all uncommon.

Cancer of the breast is one of the three most common cancers among women. One in nine women will develop breast cancer in her lifetime. But breast cancer does not develop overnight. It usually begins as a small mass in the breast, which grows ever so slowly for a long time. It is at this stage that a woman should go to a doctor and have the mass examined and biopsied. Most breast masses are benign, but the cost of ignoring a mass that might be malignant is very high. Every day women die of breast cancer which could have been treated if detected in time.

In my experience, most women who don’t see a doctor for a breast mass are reluctant because they are shy to talk about the issue. In other cases, women simply don’t want to ‘waste’ limited resources on their own health. These are terrible reasons to risk the life of a mother, a sister or a daughter.

Unless we start to get over our hang ups and actually talk about this issue, we will never be able to educate women and their families about the risks of breast cancer. We must change our collective attitude towards women’s health and breast cancer and encourage awareness. Only then will these sad stories become less frequent.

Note: an earlier version of this post was titled “Lets talk about breasts”. This has been changed at the request of the writer.

Omar Chughtai

Omar Chughtai

An avid reader of blogs who works as Lab Director at Chughtais Lahore Lab. Omar tweets @OmarChughtai.

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • Parvez

    On reading your article I could not but notice one of the reasons for not coming forward was ‘ not to waste limited resources ‘ this should tell you the medical profession that something is wrong on your side as well.
    Today an average middle class person finds it a strain to see a good doctor or go to a hospital for a procedure, let alone the poor.Recommend

  • Taimoor

    nice message, wrong grammar.Recommend

  • faraz

    Lets talk about breast cancer, would have been a proper headingRecommend

  • JohnnyEnglish

    You could have called the article “Lets talk about mamry gland cancer” why the double meaning? I can see the liberals ranting against me nowRecommend

  • Ammara Farooq Malik

    Great post Omer! And yes I completely agree that one sad reason for women to not come forward in our society with their own health concerns is because they feel that the limited resources of time and money should be better spent on their children or even husbands…and their own health comes in last. It is the typical eastern thinking pattern but one which really should change for the well being of the entire family. Any resources saved at the expense of a mother’s health are really not a saving at all.Recommend

  • fiya

    very well- written.Recommend

  • farah lodhi

    very nice Mr. Chughtai!

    it is essential to spread awareness among women b/c as u said most of them feel shy even to share their problem with their family members. Confidence building is badly needed among family so that girls/ladies can discuss any such thing without hesitation.

    Nice effort by you, by the way the title is very CATCHY of course :)

    FARAH IQBAL LODHI.
    Dow University.Recommend

  • Reader

    It is very important to create awareness and make women feel confident about their their body parts and that none of them is vulgar.

    I had a breast tumor when I was 20 and I remember how afraid I was to see a bulging mass protruding from my body. I got so scared and certain that it was Cancer that going to the doctor only seems to bring confirmation. For a year, I remained in a Zombie state and when I found out that the tumor would not dissolve mysteriously by mere prayers, I had to overcome my embarrassment and tell my mother.

    Thanks to my tender age, the tumor didn’t spread and remained benevolent.Once you cross thirty, the plastic surgeon told me, chances are that every tumor in your body is Cancerous.

    Thank you for writing this article and creating awareness, Omar sahab.Recommend

  • Anthony Permal

    Thank you for writing about this.

    I can easily relate to this as my mother – although by the grace of God and medical help she survived – did not tell us for 2 years that she had a mass. When we found out, she told us she didn’t want to burden our lives and finances.

    I have tears in my eyes thinking about that day, and just how much we undervalue the love of the women in our lives.

    I urge all you men out there, PLEASE take your mother, sister, wife, aunt etc for a mammography TODAY!

    And yes, I agree that it is extremely expensive when you take actual medical costs for treatment in mind, which also worsens the situation. You didn’t mention that part, sir.Recommend

  • umar

    nice effort to bring up awarence Recommend

  • http://www.omarchughtai.com Omar

    Thank you for your comments everyone.
    The original title for this blog post was ‘Breast Cancer – Early detection is key.’

    The title was changed to ‘Lets talk about breasts’ by the editors without my knowledge. I think that title does not reflect the serious nature of the topic. Upon my request they have now changed the title to ‘Lets talk about breast cancer.’

    You are welcome to view the article and leave more comments on my website at http://www.omarchughtai.comRecommend

  • eyeroll

    Really useful article for women, but ET do you really need to resort to a crass and sensationalist headline for such a respectable article? Havent the last few days of ‘Mufti sahab helped me come out of the closet’, “No I dont pray Jummah’ attention seeking enough? You are a respectable paper not a page 3 rag!Recommend

  • http://www.omarchughtai.com Omar

    Thank you so much for your comments.

    The original title of this post was ‘Breast Cancer – Early Detection is Key.’
    The title was changed by the Express Tribune editors without my knowledge or consent. I believe ‘Let’s Talk About Breasts’ does not reflect the serious nature of the topic.
    They have changed the title to ‘Let’s Talk about Breast Cancer.’ Recommend

  • Mahreen

    Good write up .. we really need to work as medical professionals seriously and create awareness about this issue. Other than the marketing that companies do on Breast Cancer Awareness in October, one needs to take more initiatives in the rural community to have outreach programs on awareness and even about the SBE procedures in women.

    Moreover, one can always start from home and bring awareness to the family members and even amongst the maids and drivers working at your residences.Recommend

  • Hassan

    Good article! Made many unawares Aware of this disease! Recommend

  • http://lonepkliberal.wordpress.com Loneliberal PK

    There’s nothing “shameful” about any part of the human anatomy, and it’s time that we all grow up.Recommend

  • We all have them.

    Yes, even men. Everyone has breasts. So why can’t we talk about them? “Breast’ isn’t a bad word. If the idea of saying breast wasn’t so taboo then maybe women would feel more open to reporting masses and early detection would be possible. If we even poopoo the word then I shudder to think how a woman with an actual problem would feel when asking her doctor to look at her in her ‘forbidden areas’. Lets talk about breast because that’s the ONLY way we will talk about breast cancer.Recommend

  • raised eye brow

    ditto eyeroll

    get serious ET!Recommend

  • Ali from Karachi

    I think the first, and the most important step, in our society will be greater prevalance of lady doctors. Let’s be honest, men from rural areas will remain reluctant of approaching a male doctor with regards to such issues.Recommend

  • http://bakedsunshine.wordpress.com Shumaila

    Thank you for writing about this. I’ve come across patients with the same late diagnoses and self-abnegating reasons for not gaining treatment. Cancer affects us all, and breast cancer is a silent and deadly killer that not only takes away life but maims and worsens it too. And if we won’t increase awareness about it then it will simply go on wreaking havoc. Recommend

  • LOveableLion

    Well! this is the crucial post by all means. As a matter of fact each women in pakistan should be appriciated for their health concerning issues, especially from the backward areas, which pitty beings are not fecilitiated for cureing their seasonal fever either…
    the solution of the problem should be provided through the Government, nevertheless Pakistan is one of the weakest Government implemented country in the world, still it should concentrate on the healths of females, because they are`nt able to take care of themselves…Recommend

  • Shahid3

    How a feeling of shame and feeling uncomfortable with ones own body is drilled into 12 year old heads:

    Like any other healthy 12 year old female–but much to my mother’s consternation–I sprouted breasts…At the age of 16 I discovered that I was not alone. Every “good” young woman I knew had bad posture. The becharees who were well endowed would go to great lengths to distort their body in any way short of actually crossing their arms across their offending chests (which would only have drawn more attention to them). Having them at all was a threat to and a defiance in the face of our paak-saaf society, but having ones above the respectable-acceptable limit was somehow even more criminal. So among my friends and cousins, big cotton dupattas were carefully arranged and kameezes were artfully stitched to control 16-17 year old anatomies threatening to break free and wreak havoc over good, civilized men. I was lucky, in a manner of speaking, being, hmmm, small boned. But, even my meager endowment could be a deadly menace if unleashed on the unsuspecting Pakistani man.

    …It took me a long time to realize this. Much, much longer to stop feeling ashamed. Every day I have to remind myself not to be embarrassed. And I suppose that writing this piece is part of that effort. I try, at least, to run without shame and laugh without shame and dance without shame. But my spine is still bent from having been crushed under the weight of sharam for years. I can’t get my posture back. Theek hai. I accept my imperfect woman’s body.Recommend

  • Survivor

    Very nice article, but sir please shed some light on the male cancers as well especially testicular cancer. as lots of young men are subjected to this deadly disease but because of the social norms and sensitivity they are hesitant about discussing it and revealing it. an article regarding this disease would be immensely appreciated. Recommend

  • vicious_circle

    Sorry could not help but notice the url to the blog.. got me giggling..
    http://blogs.tribune.com.pk/story/8418/lets-talk-about-breasts/

    Just saying… :pRecommend