Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a selfadministered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.
We report a case of a 65-year-old man who presented to the Endocrine service for hypercalcemia. He had painful joints, muscle aches, joint stiffness, and incidentally discovered elevated calcium levels on two separate occasions. A lab evaluation indicated non-parathyroid mediated hypercalcemia with calcium levels in the range of 10.1-10.5mg/dl. Parathyroid hormone related peptide (PTHrP) level was undetectable. His PTH and 25-OH Vitamin D levels were normal. But his 1, 25 Dihydroxy Vitamin D levels were low. Initial imaging revealed a heterogeneously enhancing mass on the posterolateral left kidney. Our patient underwent a left nephrectomy, and the mass was identified as RCC on surgical pathology. We illustrated the differential diagnosis of hypercalcemia and the evaluation of hypercalcemia occurring with RCC. This case explains that we need to carefully evaluate, interpret, and review all the data, especially when the patient has borderline elevated calcium levels and does not have a typical presentation of malignancy
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