1. Review of Country Specific Evidence to Strengthen Early Detection of Breast Cancers in Sri Lanka Dr. Suraj Perera MBBS, MSc, MD Consultant Community Physician National Cancer Control Programme Ministry of Health Sri Lanka

4. Data coding & classification

5. Surveillance of Cancers Cancer Incidence Data 2001-2005 Available on line at http://www.health.gov.lk/cancer.htm http://www.health.gov.lk/cancer.htm

6. Incidence of all cancers in Sri Lanka YearNo.Crude incidence rate (per 100,000 population) 1985501231.6 1990606335.7 1995732540.4 20001092556.4 20051337267.9

8. Incidence of Breast Cancers among Females (1985 – 2000) YearIncidence of Breast Cancers Among Females No. newly diagnosed % out of all female cancers Relative Rank among Female Cancers 198553121.6%2 199064020.7%2 199587422.5%2 2000132422.8%1 2001154826.2%1 2002158024.8%1 2003163125.3%1 2004174624.9%1 2005185925.4%1

9. Leading cancer sites- 2005 (Females) SiteNo.Crude rateAge standardized rate Breast185918.718.3 Cervix uteri8818.9 Ovary5966.05.9 Thyroid5926.05.9 Oesophagus5245.35.5 Lip, oral cavity & pharynx 3773.8 Colon & rectum3533.53.6 Leukaemia2572.62.8 Lymphoma2432.42.5 Uterus2372.4

10. Leading cancer sites – Females (2005)

11. Crude Incidence Rate of Breast Cancer

15. Breast cancer incidence by district, Sri Lanka – 2005

16. Morphology of Female Breast Cancers ( 2000- 2005) Histology Type No% Infiltrating ductal carcinoma 778380.3% Lobular carcinoma 3393.4% Non infiltrating intraductal carcinoma 6 Infiltrating duct & lobular carcinoma 7 Medullary carcinoma 59 Inflammatory carcinoma (Paget disease) 16 Sarcoma 21 Lymphoma 4 Melanoma 2 Phyllodes tumour 50 Others (including unclassified) 140114.4% Total 9688

17. Research Evidence - Breast Cancer Epidemiology Retrospective analytical study –Breast Cancer Patients presented to the Professorial Surgical Unit, NCTH 2000 – 2010 Results 134 patients 67% above 50 years (mean age 52 years) 75% patients detected lump accidentally 20% patients detected due to pain 9.7% did breast self examination 58% delay in seeking treatment > 3 months 50.7% locally advanced breast cancer (Bandara DMSM, Ariyarathna MHJ ‘Delay in diagnosing female breast cancer’ Ceylon Medical Journal, Vol 55 Supplement 1, June 2010, pp 66)

18. 8/26/2015 Early Detection Strategies of Breast Cancer

19. 8/26/2015

22. THANK YOU National Cancer Control Programme Ministry of Health 555/5, Ground Floor Public Health Complex Elvitigala Mawatha Narahenpita Colombo 5 Tel No. +94 -011-2368627 E mail nccpsl@yahoo.com