“Breast cancer is one of the most common cancers in Pakistani women. The average risk of a woman in Pakistan developing breast cancer sometime in her life is about 13%. This means there is a 1 in 9 chance she will develop breast cancer,” a seminar was told in Karachi.
“If you notice a lump, do not panic because 8 out of 10 cases of breast lumps are not cancerous such as cysts or fibroadenomas. However, any new lump should be checked promptly to rule out malignancy. A breast cancer caught in its early stages has a 90% survival rate for patients, and can increase chances of getting well considerably,” said Prof. Najeeb Naimatullah, (Diplomat American Board of internal Medicine, Haematology and Medical Oncology), Consultant Medical Oncologist and HoD at the SIUT and Patel Hospital, while speaking at the Breast Cancer Public Awareness Seminar held recently at the NCCI in connection with World Breast Cancer Month.
Prof. Naimatullah said that women in Pakistan are unaware of the seriousness of the breast cancer and have shied away from talking about it, taking precautions, or getting them tested, it’s high time we all united against breast cancer to protect our women from this silent killer because breast cancer is the leading cause of death of more than 50,000 Pakistani women every year.
“Cancer treatment is leaving behind its rigid, conventional approach and stepping into a new era, one where therapies are as unique as the patients themselves. With precision medicine gaining momentum, hospitals are leveraging genetic profiling and immunotherapy to craft highly personalized treatment plans, drastically improving outcomes while minimizing unnecessary side effects.”
Prof. Naimatullah further said: “Genetic profiling allows oncologists to pinpoint specific mutations that drive cancer growth, making treatments far more effective.”
“By analyzing a patient’s genetic makeup, doctors can determine which therapies will work best, steering away from the trial-and-error approach of conventional treatments. Immunotherapy, which uses the body’s immune system to target and destroy cancer cells, is another game-changer. When combined with biomarker testing, it enables specialists to predict which patients will benefit most from treatments like immune checkpoint inhibitors. We have adopted comprehensive molecular testing to guide therapy selection, ensuring that patients receive the most effective, least toxic treatments available,” he elaborated.
“The idea is to use molecules known as checkpoint inhibitors, which prevent cancer cells from shutting down the immune response launched by the patient’s own body, and because most tumors do launch some sort of immune response, medical oncologists expect that more and more immunotherapy drugs will become approved over the next few years.”
Immunotherapy is usually given as a single agent or two different agents and can be combined with other treatments such as chemotherapy or targeted therapy. Compared to traditional forms of cancer medicine like chemotherapy, immunotherapy produces much fewer side effects. In addition, it can be targeted to attack only cancer cells, without damaging other healthy tissue as often happens with chemotherapy.
“The patients who respond to these drugs go into remissions measured not in extra weeks or months of life, but lifetimes,” Prof. Najeeb explained.
Also speaking at the seminar, guest speaker Prof. Fareya Usmani, consultant and general surgeon, said: “Breast removal for treating breast cancer is outdated, inhumane and can be avoided regardless of how terminal the case might be. Advances in surgical techniques now allow doctors to preserve more breast tissue, reduce scarring, and promote faster emotional and physical recovery. Still, choosing between breast conserving surgery and a mastectomy can be complex, involving careful consideration of medical, personal, and emotional factors. Depending on the patient’s needs, reconstruction may involve reshaping remaining breast tissue, using an implant, or transferring tissue from another part of the body through microsurgery” these views were shared by guest speaker.”
“These procedures reduce the negative physical and emotional experiences after a mastectomy, while improving body image and quality of life, techniques like skin- and nipple-sparing mastectomy, targeted lymph node procedures (sentinel node biopsy), and immediate reconstruction allow for better cosmetic results and shorter recovery times,” said Prof. Fareya.
Despite the medical progress, awareness about reconstruction remains limited, particularly in Pakistan. Many women are unaware that reconstruction can often be performed at the same time as their mastectomy, eliminating the need for additional surgeries later, added Prof. Fareya.
Breast cancer is typically treated using a technique called external beam radiation therapy. Radiation oncologists use a machine called a linear accelerator (LINAC) to deliver beams of radiation to a specific area of the body. These beams can be made of high-energy photons, electrons or protons to deliver the radiation dose, said guest speaker Prof Ahmad Nadeem Abbasi, consultant radiation oncologist, chair education programs at the AKU and general secretary of the Radiation Oncology Society of Pakistan.
Three-Dimensional Conformal Radiation Therapy (3D-CRT) uses multiple beams to deliver radiation to the high-risk areas of recurrence within the breast or chest wall and regional draining lymph nodes, says Prof. Ahmad Nadeem Abbasi.
Volumetric modulated arc therapy (VMAT) uses a rotating beam of radiation to deliver doses at many angles. As the treatment machine rotates, the radiation beam is shaped with metallic leaves to carefully adjust the amount of dose that is delivered at each angle. For some patients, this can improve how the dose is delivered while reducing radiation to healthy organs. Proton therapy uses a radiation particle called protons to deliver the radiation dose directly to the tumor. For some patients, this allows for reduced radiation to healthy organs and tissues.
Adeel Ahmed, advisor to the chairman of Neurospinal & Cancer Care Postgraduate Institute, said that tradition of NCCI is to introduce new and novel modalities in Pakistan to extend and enhance human life. A recent example is Gamma Knife Esprit which is an effective treatment for brain metastases from breast cancer, offering a high rate of local control with minimal invasiveness. It is a precise, non-invasive; single-day treatment that helps preserve cognitive function compared to other radiation techniques and is effective even for multiple metastases. This is a logical and rational solution of brain metastasis because systemic therapies used for breast cancer cannot penetrate the blood brain barrier. It is so horrible that 20% to 40% breast cancer patients will develop brain metastasis, while patients with TNBC & HER2-positive reaching to 45%-50%.
Published in The NEWS on October 27, 2025.