Breast diseases are a leading disorder of females worldwide. Breast cancer being at the top, benign disorders are encountered not infrequently.
Breast screening services are an essential component of any facility claiming to foster Women’s Health and well-being.
Pakistan being one of the few countries in Asia with the highest incidence of breast cancer, voids in Research for in-depth study of this disorder impose a moral obligation on health care services to delve into seeking novel/ existing risks contributing to high prevalence.
South City Hospital has established itself as a facility envisioned with quality care.
With ready access to the premises, both by patients and physicians, there emerges a need to modify its outward visage beyond therapeutic services.
A major incentive to achieve this is non-financial, the prorating time between clinical care, training, and research.
Henceforth Breast Services is foreseen to be not just a service providing surgical consultation and treatment, but establishing an excellent comprehensive program encompassing Awareness, Screening, MDT planning of Oncological care, Cancer Survivorship, and Data Base for Research. Training is foreseen to be a visible entity for both Medical and Ancillary personnel.
AWARENESS
Early detection of breast cancer is now well-established as a key factor in improving survival. With a deft of awareness in masses, cases present at a late stage. Regular educational activities to enhance print and informative sessions are required. At least annual events marked with Breast Cancer promotional periods would be required.
SCREENING
Besides catering to routine screening of women with average risk, service for screening of high-risk women needs to be established. This would entail Genetic Counselling and Screening for Mutation.
It is foreseen that this would yield high patient volumes commensurate with state-of-the-art imaging and diagnostic services for rapid One Stop Clinic processing.
To secure top crust competitive entity, Digital mammography with Tomosynthesis. Ultrasound and Breast MRI are the best options.
To complement early detection, image-detected lesions warrant the expertise of image-guided biopsy inclusive of Stereotactic techniques. The futuristic vision would deploy an MRI-guided biopsy facility also, currently not available in Pakistan.
HIGH-RISK SCREENING SERVICE
Rapid advancement to detect mutations over and above BRCA I & BRCA II for Hereditary syndromes is the call of the day. With limited Genetic Counselling services locally, innovations through Telemedicine consultations can be offered. With risk stratification of individual patients for screening, chemoprevention can be planned.
BREAST SURGERY
Surgical expertise with current practices encompassing Breast Conservation, Ablative, and Reconstructive procedures is essential.
Oncoplastic Breast Conserving surgery is undeniably the want of the day. Ablative procedures should be complemented with Immediate or Delayed Reconstructions
Nipple-sparing, Skin Sparing Mastectomies with well-selected patients offered reconstructions should be the target. Support services for those forfeiting reconstruction and prosthetic replacement to sustain body image should be ensured.
MDT
Multidisciplinary Teamwork via Tumour Board is the backbone of comprehensive cancer care. Both for new entrants as well as members of the survivor’s group. This facility should cater to both patients as well as trainees aspiring in the field of Breast Cancer Care.
TRAINING
As foreseen, a State of Art facility should be fully encashed to benefit trainees in Clinical as well as Ancillary services. With the recent approval of Breast Fellowship by CPSP trainees would seek affiliation with experts to enhance their knowledge and clinical acumen
SURVIVORSHIP
Mandatory to providing therapeutic care for cancer patients, a survivorship service should also be made available for in-house and external survivors.
DATABASE
As the service develops a prospectively maintained database is essential to study disease patterns as well derive research directions.
To accomplish the projected tasks, a significant investment of person-hours and workforce would be required. It is foreseen that a well-planned strategy should fruition the outcome.
