Ayda Hussain Omer Mustafa*

University of AL-Neelain, Sudan

*Corresponding Author: Ayda Hussain Omer Mustafa, University of AL-Neelain, Sudan.

Received: January 25, 2021; Published: July 22, 2021

Abstract

Introduction: Breast cancer is the most common cancer among women in Sudan and Greece. Once diagnosed, the female patient undergoes several medical interventions for diagnosis and treatment such as surgery, chemotherapy, hormonal or radiation therapy and this period is very stressful for the patient, her family, husband or spouse.

Aim of the Study: Our aim was to investigate the impact of breast cancer diagnosis and treatment on the patient’s marital status as well as on patient’s social life and their career. We included patients from Greece and Sudan, taking into consideration the differences in social and educational status; we explored the possibility of different responses between the two countries.

More specifically, we compared the divorce rates between a group of women diagnosed with breast cancer and those of a control group in both countries. Furthermore, we recorded the impact of breast cancer on the patient’s as well as on her husband’s career.

Methods: The is a comparative cross sectional case control study. It was conducted at Bashair Teaching hospital of Alneelain university and Elsharif Hospitals in Sudan and Hippokrateion University General Hospital and Alexandra University General Hospital in Athens, Greece. Inclusion criteria were married female patients diagnosed with breast cancer at any stage and treated. 100 patients from Sudan and 94 patients from Greece were included in the study and were compared to a control group of patients diagnosed with benign lesions, consisting of 100 patients from Sudan and 66 patients from Greece.

Results: The survey of participants showed that, in Greece most of control (53 of 65, 94.6%) and patients (65 of 79, 82.3%), were still married at the time of the study, the same result showed in Sudan, (86 of 90, 95,5%) of the control group, and (87 of 98, 89.7%) of the group of patients were still married at the time of the study, the frequency distribution was significant with p-value of Chi-square test (.047). The difference in frequency distribution of partner's occupation after diagnosis and treatment of breast cancer, was not significant among Greeks, where the more affected ones were employees, (29, 58%) for controls, and (32, 53.3%) for patients), and the p-value of Fisher Exact test (.362), also in Sudanese the frequency of employees was (53, 57%) for control and (34, 64.2%), with p-value of Fisher Exact test (.686)). The status of partner's work in Greece resulted significant difference in frequency distribution, where the frequency of the group that their work did not affected was increased from controls (24, 48.1%) to among patients (48, 65.8%), and the frequency of group that changed to the best also increased from controls (0, 0%) among patients (2, 2.7%), while the changing to the worst decreased from controls (27, 51.9%) to (23, 31.5%) in patients, these differences between controls and patients were significant with p-value of Fisher Exact test (.032) . while no significant differences noticed among Sundance respondents where the frequency distribution was (70, 79.5%), and (82, 87.2%) for no changes in control and patients respectively, (2, 2.3%), and (5, 5.3%) for changes to the best in control and patients respectively, (16, 18.2%) and (7, 7.4%) for change to the best in control and patients respectively, with p-value of Fisher Exact test (.058).

Conclusion: Divorce is not common among breast cancer survivors in Greece and Sudan in spite of the different cultural and lifestyle modalities of life. Long term survivors diagnosed with breast cancer may return to their career, some of them may have achievements that are not reached by their healthy mates in Greece and Sudan.

Recommendations: It is urgent to have strategic plans to increase awareness for early detection, accurate diagnosis and comprehensive management as well as follow up programs of breast cancer both in Greece and Sudan. It is very important to have psychiatry groups to support the breast cancer patients and their families especially during the first two years. It is essential to support and rehabilitate the breast cancer survivors and their families to return to their previous activities.

Keywords: Breast Cancer; Sudan; Greece

References

1. Marwa Maweya Abdelbagi Elbasheer., et al. “Spatial distribution of breast cancer in Sudan 2010-2016”. PLoS One9 (2019): e0211085.
2. National Plan for Breast Cancer 2011-2015 (2018).
3. Intisar E Saeed., et al. “Cancer incidence in Khartoum, Sudan: first results from the Cancer Registry, 2009-2010”. Cancer Medicine (2014).
4. Ferlay J., et al. “Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012”. European Journal of Cancer 49 (2013): 1374-1403.
5. Gogas H., et al. “Survival from breast cancer in relation to access to tertiary healthcare, body mass index, tumor characteristics and treatment: Panagopoulou P”. European Journal of Epidemiology 27 (2012): 857-866.
6. Greer S., et al. “Psychological response to breast cancer: effect on outcome”. Lancet 13 (1979): 785-787.
7. Asmerom Tesfamariam Sengal., et al. “Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case”. BMC Cancer 17 (2017): 804.
8. Agboola AJ., et al. “Molecular characteristics and prognostic features of breast cancer in Nigerian compared with UK women”. Breast Cancer Research and Treatment 2 (2012): 555-569.
9. K D Awadelkarim., et al. “Pathological, clinical and prognostic characteristics of breast cancer in Central Sudan versus Northern Italy: implications for breast cancer in Africa”. Histopathology4 (2008): 445-456.
10. Bray F., et al. “The changing global patterns of female breast cancer incidence and mortality”. Breast Cancer Research 6 (2004): 229-239.
11. Veronesi U., et al. “Breast cancer”. Lancet9472 (2005): 1727-1741.
12. Basro S and JP Apffelstaedt. “Breast cancer in young women in a limited‐resource environment”. World Journal of Surgery 7 (2010): 1427-1433.
13. Vorobiof DA., et al. “Breast cancer incidence in South Africa”. Journal of Clinical Oncology 19 (2001): 125S-127S.
14. European Council. Recent Demographic Tendencies in Europe, 1993, European Council, Strasbourg (1994).
15. Khalifa M., et al. “Marriage pattern in the Sudan and its interrelation with fertility”. Population Bulletin of ECWA 28 (1986): 43-67.
17. Ibrahim G Alghamdi., et al. “Early marriage is a potential risk factor for female breast cancer in the Eastern Region of Saudi Arabia” (2015).
18. Menglin Li., et al. “Does marital status correlate with the female breast cancer risk? A systematic review and meta-analysis of observational studies”. PLoS One3 (2020): e0229899.
19. CK Gajalakshmi and V Shanta. “Risk Factors for Female Breast Cancer A Hospital-Based Case-Control Study in Madras, India, Breast cancer and ages at first marriage and first birth: a new hypothesis”. Acta Oncologica5 (1991): 569-574.
20. Elgaili M Elgaili., et al. “Breast cancer burden in central Sudan”. International Journal of Womens Health 2 (2010): 77-82.
21. Mohamed Toum Musa M., et al. “Postmastectomy life quality in patients with breast cancer in Khartoum” (2008).
22. Krieger N., et al. “Measuring social class in public health research: concepts, methodologies, and guidelines”. Annual Review of Public Health 18 (1997): 341-378.
23. Yang Liu., et al. “Influence of occupation and education level on breast cancer stage at diagnosis, and treatment options in China. A nationwide, multicenter 10-year epidemiological study”. Medicine (Baltimore) 15 (2017): e6641.
24. Nancy Waxler-Morrison., et al. “Effects of social relationships on survival for women with breast cancer: a prospective study”. Department of Anthropology/Sociology, University of British Columbia, Vancouver and ‘Division of Epidemiology, Biometry and Occupational Oncology, British Columbia Cancer Agency, Vancouver, Canada.
25. Krieger N., et al. “Measuring social class in public health research: concepts, methodologies, and guidelines”. Annual Review of Public Health 18 (1997): 341-378.
26. Liberatos P., et al. “The measurement of social class in epidemiology”. Epidemiology Review 10 (1988): 87-121.
27. Lynch JW., et al. “Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction?” American Journal of Epidemiology 144 (1996): 934-942.
28. Sara McLafferty., et al. “Rural - urban inequalities in late-stage breast cancer: spatial and social dimensions of risk and access”. Environment and Planning B: Planning and Design 4 (2011): 726-740.
29. Xiaopan Li., et al. “Urban-Rural Disparity in Cancer Incidence, Mortality, and Survivals in Shanghai, China, During 2002 and 2015”.
30. Neuhausen SL. “Ethnic differences in cancer risk resulting from genetic variation”. Cancer 86S (1999): 2575-2582.
31. Naomal MA PERERA and Gerald PH GUI. “Multi-ethnic differences in breast cancer: current concepts and future directions”. Academic Surgery (Breast Unit), Royal Marsden NHS Trust, London, United Kingdom (2003).
32. Newman LA., et al. “African-American ethnicity, socioeconomic status and breast cancer survival”. Cancer 94 (2002): 2844-2854.
33. S. Library of Congress.
34. Greek Cultural Profile. Diversicare (2006).
35. C H Paalman., et al. “Years after breast cancer diagnosis: a population-based study”.
36. C H Paalman., et al. “Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study”. British Journal of Cancer 114 (2016): 81-87.
37. , et al. “The Likelihood of Returning to Work After Breast Cancer” (1995).
38. Baider Ever-Hadani., et al. “Is perceived family support a relevant variable in psychological distress?. A sample of prostate and breast cancer couples”. Journal of Psychosomatic Research5 (2003): 453-460.
39. “Introduction to group interventions for trauma survivors”. December 2001 Group Dynamics Theory Research and Practice 5.4 (2001): 246-251.
40. Shelby Langer., et al. “Care Giver and patient marital satisfaction and affect following hematopoietic stem cell transplantation: a prospective, longitudinal investigation”. Psychooncology 3 (2003): 239-253.
41. Albrektsen G., et al. “Breast cancer incidence before age 55 in relation to parity and age at first and last births: a prospective study of one million Norwegian women”. Epidemiology 5 (1994): 604-611.
42. Albrektsen G., et al. “The short-term and long-term effect of a pregnancy on breast cancer risk: a prospective study of 802,457 parous Norwegian women”. British Journal of Cancer 72 (1995): 480-484
43. Basro S and JP Apffelstaedt. “Breast cancer in young women in a limited‐resource environment”. World Journal of Surgery 7 (2010): 1427-1433.
44. Vorobiof DA., et al. “Breast cancer incidence in South Africa”. Journal of Clinical Oncology 19 (2001): 125S-127S.
45. Montazeri A. “Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007”. Journal of Experimental and Clinical Cancer Research 27 (2008): 32.
46. Elhoweris Mohammed. “Sudan First International Conference on Breast Cancer 5th-7th December 2011, Khartoum Sudan”. Sudan Medical Journal1 (2012).
47. Russo J and Russo IH. “The role of estrogen in the initiation of breast cancer”. The Journal of Steroid Biochemistry and Molecular Biology 102 (2006): 89-96.
48. Cavalieri E and Rogan E. “The molecular etiology and prevention of estrogen-initiated cancers: Ockham’s Razor: pluralitas non est ponenda sine necessitate. Plurality should not be posited without necessity”. Molecular Aspects of Medicine 36 (2014): 1-55.
49. Lovett JL., et al. “Oral contraceptives cause evolutionarily novel increases in hormone exposure: a risk factor for breast cancer”. Evolution, Medicine, and Public Health 2017 (2017): 97-108.
50. Gierisch JM., et al. “Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review”. Cancer Epidemiology, Biomarkers and Prevention 22 (2013): 1931-1943.
51. Finlay-Schultz J., et al. “Steroid hormones, steroid receptors, and breast cancer stem cells”. Journal of Mammary Gland Biology and Neoplasia 20 (2015): 39-50.
52. Mohammed H., et al. “Progesterone receptor modulates ERalpha action in breast cancer”. Nature 523 (2015): 313-317.
53. McFall T., et al. “Progesterone receptor A promotes invasiveness and metastasis of luminal breast cancer by suppressing regulation of critical microRNAs by estrogen”. Journal of Biological Chemistry 293 (2018): 1163-1177.

Citation

Citation: Ayda Hussain Omer Mustafa. “Impact of Breast Cancer on Marital Status. A Case Control Study in Sudan and Greece”.Acta Scientific Medical Sciences 5.8 (2021): 93-109.

Copyright

Copyright: © 2021 Ayda Hussain Omer Mustafa. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.