Risk Factors of Breast Cancer in Bahrain

Background: Breast cancer is the most common cancer in females worldwide, and the second leading cause of cancer deaths in women. It is accounting for 32% of all cancers. It is well known that gender, age, past history of malignancy, family history of malignancy, prolonged uninterrupted exposure to estrogen are recognized risk factors of breast cancer. Few studies on risk factors in Bahrain were performed. Objective: To assess the primary risk factors of breast cancer in patients living in Bahrain. Setting: All patients operated by the two senior authors in Salmaniya Medical Complex and Ibn Al-Nafees hospitals in Bahrain. Design: Prospective study. Method: A clinical review of 105 breast cancer patients performed from August 1999 to September 2008. Bahraini and non-Bahraini patients are included. Presentation, diagnostic approach, and management were evaluated. Characteristic data included were age at presentation, age at menarche and menopause. Other factors age at first full term pregnancy, history of lactation, history of using hormonal replacement therapy, history of using oral contraceptive pills, past personal history of malignancy and, type of malignancy, family history of breast cancer. Result: One hundred and five patients, all were females. The age of patients at diagnosis was categorized as follows: less than 35 years old were 10 patients (9.5%), 35-45 years were 33 patients (31.4%), 46-55 years were 30 patients (28.6%) and more than 55 years old were 32 patients (30.5%). Twenty patients had early menarche (19%), 3 patients (2.8%) had late menopause. Twenty patients were nulliparous (19%). Six patients (5.7%) had their first delivery at an age of more than 30 years while those who had their first delivery at less than 30 years of age were 79 patients (75.2%). Lactation history was negative in 27 patients (25.7%). Twenty-one patients (20%) used Oral Contraceptive Pills (OCP) for long periods. Two patients (1.9%) only were on Hormonal Replacement Therapy (HRT). Two patients (1.9%) had positive past personal history of malignancy (breast and ovaries). Twenty-two patients (20.9%) had positive family history of breast cancer. Conclusion: Almost 70% of our patients were below or equal to 55 years at presentation. Family history was found significantly higher in our patients (20.9%).