The Tribune

By DANA SMITH dsmith@tribunemedia.net WITH breast cancer at record levels in the Bahamas, and recent studies indicating that Bahamians have the highest prevalence of a mutated gene responsible for causing the disease, health professionals are concerned that diagnostic tools may not be up to industry standards. Bahamian women are falling prey to breast cancer at an unusually early age, and more aggressive strains of the disease are becoming prevalent. Also alarming is the claim by healthcare professionals that breast cancer diagnostic tools in the Bahamas are old and slow. Michelle Rassin, an industry professional at Ports International, said the mammogram machine at Princess Margaret Hospital (PMH) is nearly "obsolete." "The current machine at PMH is over ten years old and is pretty much obsolete in today's health care standards," she said. Ms Rassin explained that although the mammogram machine does work, "it's slower than current machines" and "the accuracy of the new state-of-the-art machines is much greater." She could not give a figure for how many persons the PMH mammogram machine could accommodate in a day compared to a new machine, but stated: "I'm sure they could probably double their volume (of patients) with a new machine." PMH Oncologist Dr DuVaughn Curling said the hospital would "benefit greatly" from a new mammogram machine, but not necessarily because of an increase in the number of patients that could be seen. He explained that if PMH were to get a digital machine, the mammogram images would be higher quality and could be sent more immediately to other locations if further analysis is needed. "What it can improve upon is the quality of the image and the number of people who will be able to access it for study," Dr Curling said. "For example, if someone in Grand Bahama gets a mammogram on a digital machine, five minutes later a doctor in Nassau can see it on a computer." However, both Ms Rassin and Dr Curling agree a new mammogram machine is necessary because of the sheer number of breast cancer cases in the Bahamas. "Breast cancer is prevalent in the Bahamas because of our genetics. They've discovered Bahamians are more susceptible to breast cancer at an earlier age and to a more aggressive form," Ms Rassin said. "One in four persons is affected with breast cancer so it's important for Bahamians to get checked and get their mammograms." There are "a lot of things we can do" to fight against breast cancer in the Bahamas, she continued. "We can increase the research, increase the education, increase awareness, and increase the standard of the diagnostic tools so that we can diagnose it." In a study done by Dr Judith Hurley, along with five other researchers, she discovered that in the Bahamas, "48 per cent of the patients with breast cancer are under 50 years old." Dr Hurley claimed that "anecdotal information" suggests there is a "high incidence of breast cancer" in young Bahamian women. According to published reports, 34 per cent of Bahamian women are diagnosed at 44 years old or younger, compared to the United States where only 12 per cent of American women under 44 are diagnosed with breast cancer. This means that one in every three women diagnosed with breast cancer in the Bahamas will be diagnosed before the age of 50. Dr Hurley also documented that 48 per cent of breast cancer patients under the age of 50 have stage three cancer or higher. "This high rate of locally advanced breast cancer in very young women points to a genetic etiology," she stated. In previous media reports, Dr Hurley is reported as finding that incidences of inherited breast cancer in the Bahamas are 23 per cent, the highest rate in the world. The BRCA1 gene mutation, a breast cancer susceptible gene, is found in Bahamian women more than any other population, which puts Bahamian women at an abnormally higher risk of breast cancer than any other country. Dr Steven Narod, a cancer researcher, has said the percentage of the Bahamian females who are found with the gene is the highest he has ever seen. According to Dr Narod, the global average is five to six per cent, but 20 per cent of Bahamians sampled for the gene, tested positive ... a record high.