South Asian breast cancer patients living in Yorkshire may have higher rates of mastectomy compared with non-Asians because they present to their GPs too late, Cancer Research UK scientists report.

Research published in the British Journal of Cancer showed that 63 percent of South Asian women with breast cancer had a mastectomy compared with 49 percent of non-South Asian patients.

Researchers examined data from 1986 to 1994 on nearly 17,000 women in Yorkshire, of which 120 patients were South Asian. Preliminary findings show that the incidence of breast cancer rose faster in South Asians than in any other group.

The study, conducted at the Cancer Research UK Clinical Centre in Leeds, shows that the number of breast cancer patients is rising from Bangladeshi, Indian and Pakistani communities as these populations age and increase in numbers. Changes in lifestyle and diet contribute to this trend, but further research is necessary to explain the observed increase.

Researchers revealed that South Asian women delayed their first GP visit about initial breast abnormalities for about two months, twice as long as non-Asians. The time taken to report any breast changes can affect treatment options.

By the time of diagnosis, the tumors in South Asians were often more advanced than non-Asians and required radical surgery. Breast-preserving options, such as tumor excision followed by radio- or chemotherapy, were probably not viable alternatives in many cases.

The authors suggest that the high mastectomy rate may be a result of poor breast cancer awareness in South Asian women living in Yorkshire, compounded by low participation in breast screening.

Encouragingly, once breast cancer was diagnosed, South Asians were treated promptly and their survival was similar to non-South Asian women.

Dr. G Velikova, at Cancer Research UK says: "South Asians had a significantly longer patient-related delay before visiting their doctor, and subsequently presented with larger tumors that often resulted in mastectomy.

"It is vital that South Asian women are encouraged to take part in breast screening and that awareness of the disease is made a priority at general practices.

"There is an urgent need to explore the reasons for this delay, and to develop breast cancer awareness programs specifically targeting South Asian women to encourage participation in these communities."

SOURCES:
British Journal of Cancer, May 4, 2004
Cancer Research UK (http://www.cancerresearchuk.org)