Appropriate tool for early detection Breast Cancer in developing country; a case control study for Node negative vs Node positive Breast Cancer patients.Iran 2010

Introduction: Breast Cancer (BC) is the common cancer among women in Iranand most part of the world. It is recommended for health managers to havescreening and early detection program for breast cancer which will improvequality and quantity of patient’s life. Although the screening program may differin each country because of different resources and facilities, early detection ofbreast cancer is the corner stone of death reduction and increase survival.Mammography screening as the selected tool for early detection of breast canceris not available enough in Iran and many parts of developing countries, so it isnecessary to find out appropriate way for early detection of breast cancer andimproving survival.Here we are conducting a case control study in node negative and positive breastcancer patients and investigating the effect of clinicobiological markers on theaxillary nodal status, and overall survival. We are going to identify is there anyclinical or biological marker(s) to use as a tool for detecting the breast cancercases earlier and in node negative status as a early detecting tool in Iran.Methods: 675 breast cancer cases divided in two groups with node negative andpositive status, they investigated by clinical, pathological, and biologicalelements to find out the effective tool for early detection in negative nodal status.Results: Among 675 breast cancer patients 320 individuals were node negative(47.5%) with mean age of 48.6±11.6 years old and 355 cases were nodepositive(52.5%) with mean age of 48.2±11.1 years old and no significantdifference (p-value=0.7). The number of cases in clinical stages were extremelydifferent, more early stages including 269 cases in stage 1 and 2 in node negativegroup vs 116 cases in node positive group(P<0.0005) . There was history ofrecurrence in 12.5% and 30% in node negative and node positive grouprespectively. Primary tumor size was significantly different in two groups, it was2.9 ± 1.7 cm in node negatives and 4.2± 2.2cm in node positives (P=0.0001).There was no significant different between all pathological or biological markersin two groups.Conclusion: Among all clinical, pathological and biological markers in breastcancer patients the primary tumor size is significantly different between nodenegative and node positive groups. It is possible to use this determinant as a toolfor early detecting breast cancer cases in developing country which resources arenot sufficient for eligible women for screening program