Clinical Prevalence and Management of Breast Cancer in Selected Tertiary Hospitals in Nigeria

Download Article

DOI: 10.21522/TIJPH.2013.SE.19.02.Art026

Authors : Manir Hassan Jega, Aminu Abubakar Kende

Abstract:

Background and objective: More than half of the global cancer burden of breast cancer is found in low- and middle-income countries. The magnitude of cancer mortality will be directly related to the presentation and effectiveness of efforts to treat cancer. This study aims to determine the presentation, management and outcome of breast cancer in an African setting.

Methodology: Retrospective study of all consecutive histologically confirmed cases of breast cancer in women was extracted from patient’s clinical case notes and histopathology reports. Data was analyzed using SPSS software version 25.

Results & discussions: A total of 107 patients were seen in a period of 5 years with a breast cancer prevalence of 6.6 per 100,000. The mean age of presentation is 44.5 years. 90% presented with Invasive ductal carcinoma and 71% presented with TNM stages 3. 77% had modified radical mastectomy and 42% had chemotherapy. No patient had radiotherapy within the setting.

After six months the overall mortality was 10.3%. Only 8.4% patients were seen in the first follow up while 30% were loss to follow up.

Conclusion: The breast cancer is still a major public health concern in low- and middle-income countries. Late presentation and absence of modern management techniques contributes to the high mortality associated with the disease in this region.

Keywords: Breast Cancer, Presentation, Management, Outcome, Kebbi, Nigeria.

References:

[1].   Ferlay J, S.I., Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, and B. Forman D, F (2013), GLOBOCAN 2012 v1.0, in Cancer Incidence and Mortality Worldwide: 2013, International Agency for Research on Cancer.: Lyon, France.

[2].   Ferlay, J., et al., Global burden of breast cancer, in Breast Cancer Epidemiology. 2010, Springer. p. 1-19.

[3].   Bray, F., P. McCarron, and D.M. Parkin, The changing global patterns of female breast cancer incidence and mortality. childhood, 2004. 4(5).

[4].   Benjamin O. Anderson, Breast Cancer Epidemiology and Breast Physiology, in Ghana Breast Cancer Specialty Training Course, T.B.H.G. Initiative, Editor. 2010, The Breast Health Global Initiative: Ghana.

[5].   W.H.O, Global status report on noncommunicable diseases 2010, in WHO Library Cataloguing-in-Publication Data, D.A. Alwan, Editor. 2012: Geneve, Switzerland.

[6].   Harford, J.B., Breast-cancer early detection in low-income and middle-income countries: do what you can versus one size fits all. The lancet oncology, 2011. 12(3): p. 306-312.

[7].   Abdulrahman, G.O. and G.A. Rahman, Epidemiology of breast cancer in Europe and Africa. Journal of cancer epidemiology, 2012. 2012.

[8].   Paper, A.C.P., Access to Cancer Treatment in Low- and Middle-Income Countries. 2010, International Union Against Cancer (UICC): USA.

[9].   Nations, U., Millennium Development Goal and Beyond 2015, in Report of the UN Secretary-General. 2013.

[10].  Porter, P., “Westernizing” women's risks? Breast cancer in lower-income countries. New England Journal of Medicine, 2008. 358(3): p. 213-216.

[11].  Organization, W.H., World health day 2012. 2012.

[12].  Babatunji, O., Awareness, Attitude and Practice of Rural Women regarding Breast Cancer in Northeast Nigeria. Journal of Community Medicine & Health Education, 2012.

[13].  Odigie, V., et al., Psychosocial effects of mastectomy on married African women in Northwestern Nigeria. PsychoOncology, 2010. 19(8): p. 893-897.

[14].  Ibrahim, N. and M. Oludara, Socio-demographic factors and reasons associated with delay in breast cancer presentation: a study in Nigerian women. The Breast, 2012. 21(3): p. 416-418.

[15].  Jedy-Agba, E., et al., Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer Epidemiol, 2012. 36(5): p. e271-8.

[16].  Sharma, K., et al., A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. Journal of oncology, 2012. 2012.

[17].  Kantelhardt, E., et al., Breast cancer survival in Ethiopia: A cohort study of 1,070 women. International Journal of Cancer, 2014.

[18].  Paper, A.C.P., Access to Cancer Treatment in Low and Middle-Income Countries, in CanTreat International, Axios, V. Sowedi Muyingo, Editor. 2010, International Union Against Cancer (UICC) Conference: USA.

[19].  Anyanwu SN (2000) Breast cancer in eastern Nigeria: a ten-year review. West Afr J Med 19: 120-125

[20].  Ihekwaba FN (1992) Breast cancer in Nigerian women. Br J Surg 79: 771-775.

[21].  Althuis MD, Dozier JM, Anderson WF, Devesa SS, Brinton LA (2005) Global trends in breast cancer incidence and mortality 1973-1997. Int J Epidemiol 34: 405-412.

[22].  Adebamowo CA, Adekunle OO (1999) Case-controlled study of the epidemiological risk factors for breast cancer in Nigeria. Br J Surg 86: 665-668.

[23].  Joslyn SA, West MM (2000) Racial differences in breast carcinoma survival. Cancer 88: 114-123.

[24].  Elmore JG,Moceri VM, Carter D, Larson EB (1998) Breast carcinoma tumour characteristics in black and white women. Cancer 83: 2509-2515.

[25].  Gao Q, Neuhausen S, Cummings S, Luce M, Olopade OI (1997) Recurrent germ-line BRCA1 mutations in extended African American families with early onset breast cancer. Am J Hum Genet 60: 1233-1236.

[26].  Ntekim, A., F.T. Nufu, and O.B. Campbell, Breast cancer in young women in Ibadan, Nigeria. Afr Health Sci, 2009. 9(4): p. 242-6.

[27].  Mbuka-Ongona D, Tumbo J M (2013) Knowledge about breast cancer and reasons for late presentation by cancer patients seen at Princess Marina Hospital, Gaborone, Botswana. Afr J Health Care Fam Med 5: 1-7.

[28].  Otieno ES, Micheni JN, Kimende SK, Mutai KK (2010) Delayed presentation of breast cancer patients. East Afr Med J 87: 147-150.

[29].  Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE (2010) Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S.—a SEER analysis. BMC Cancer 10: 191.

[30].  Dodwell, D., et al., Radiotherapy following breast-conserving surgery for screen-detected ductal carcinoma in situ: indications and utilisation in the UK. Interim findings from the Sloane Project. British journal of cancer, 2007. 97(6): p. 725-729.

[31].  Cutuli, B., et al., Breast-conserving surgery with or without radiotherapy vs mastectomy for ductal carcinoma in situ: French Survey experience. British journal of cancer, 2009. 100(7): p. 1048-1054.

[32].  Ogundiran, T.O., et al., Mastectomy for management of breast cancer in Ibadan, Nigeria. BMC surgery, 2013. 13(1): p. 59.

[33].  Kemfang Ngowa, J., et al., Breast cancer profile in a group of patients followed up at the Radiation Therapy Unit of the Yaounde General Hospital, cameroon. Obstetrics and gynecology international, 2011. 2011.

[34].  El Saghir, N.S., et al., Breast cancer management in low resource countries (LRCs): consensus statement from the Breast Health Global Initiative. The Breast, 2011. 20: p. S3-S11.

[35].  Wood, A.J., C.L. Shapiro, and A. Recht, Side effects of adjuvant treatment of breast cancer. New England Journal of Medicine, 2001. 344(26): p. 1997-2008.

[36].  Anderson, B.O., et al., Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the Breast Health Global Initiative consensus, 2010. The lancet oncology, 2011. 12(4): p. 387-398.

[37].  Yip, C.-H., et al., Breast cancer management in middle-resource countries (MRCs): Consensus statement from the Breast Health Global Initiative. The Breast, 2011. 20: p. S12-S19.

[38].  Adesunkanmi, A., et al., The severity, outcome and challenges of breast cancer in Nigeria. The Breast, 2006. 15(3): p. 399-409.

[39].  Youlden DR, Cramb SM, Dunn NA, Muller JM, Pyke CM, et al. (2012) The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol 36: 237-248.