DOI: http://dx.doi.org/10.18203/2349-2902.isj20194042

Breast cancer in North-Central Nigeria: challenges to good management outcome

Ifeanyi Charles Umoke, Ekundayo Stephen Garba

Abstract


Background: Breast cancer is a major health burden globally. Now ranked the number one cancer in females, and the leading cause of cancer deaths in females in our environment, outcome indices have remained poor in developing countries. The aim of this study was to ascertain the major challenges to good management outcome of breast cancer patients in our centre.

Methods: The case notes of all histologically confirmed cases of breast cancer presenting to our centre from January 2016 to December 2017 were reviewed. Information on the variables of interest were extracted using a proforma.

Results: Fifty-five (55) patients’ case notes were reviewed. All were females. 30.9% of the patients had early disease versus 67.3% with advanced disease. 76.4% had invasive ductal carcinoma. More lesions occurred on the left and the upper outer quadrants. 46% of the 37 patients with advanced disease who required chemotherapy completed the prescribed six courses. None of the patients who required radiotherapy received it. Only 1.8% of those who required hormonal therapy were still taking them at two years follow-up. 3.6%, 11%, and 0% used alcohol, oral contraceptives and tobacco respectively. 81.8% had been lost to follow-up at two years while 14.5% had died while on admission.

Conclusions: This study identified late presentation with advanced disease; poor compliance and adherence to treatment strategies, and poor access to adjuvant therapy as the major challenges to good outcome for this disease.

Keywords


Breast cancer, Challenges, Management outcome

Full Text:

PDF

References


Clegg-lamptey JN, Baako BN, Badoe EA. The BREAST in: Badoe EA, Achampong EQ and JT da Rocha-Afodu’s Principles & Practice of Surgery Including Pathology in the Tropics. Fourth Edition, Chapter 28; 488-519

Parkin DM, Bray FI, Devessa SS. Cancer burden in the year 2000. The global picture. Ear J Cancer, 2001;4:54-66.

Adesukanmi AR, Lawal OO, Adelusola KA, Durosimi MA. The Severity, Outcome and Challenges of Breast Cancer in Nigeria. Breast. 2006;15:399-409.

Chalya PL, Chandika AB, Rambau P, Masalu N, Mabula JB, Rapesa A, et al. Assessment of quality of operable breast cancer care in a tertiary care hospital in North Western Tanzania: A single institution experience. Tanzania J Health Res. 2015;17(1):1-8.

Kene TS, Odigie VI, Yusufu IMD, Shehu SM, Kase JT. Pattern of presentation and survival of breast cancer in a Teaching Hospital in North Western Nigeria. Oman Med J. 2005;25:104-7.

Overgaard M. Radiotherapy as part of a multidisciplinary treatment strategy in early breast cancer. Eur J Cancer. 2001;37:S33-S43

Ezeome ER. Delays in presentation and treatment of breast cancer in Enugu, Nigeria. Nigerian J Clin Pract. 2010;13(3):311-6.

Fregene A, Newman IA. Breast Cancer in the Sub-Saharan Africa. How does it relate to breast cancer in Africa-American women? Cancer. 2005;4:1540-50.

Rambau PF, Chalya P, Manyama MM, Jackson KJ. Pathological features of breast cancer seen in North Western Tanzania: a nine years retrospective study. BMC Res Notes. 2011;4:214.

Mabula JB, Mabula DM, Phillipo LC, Geofrey G, Chandika A, Peter F, et al. Stage at diagnosis clinic-pathological patterns of breast cancer at Bugando Medical Centre in North-Western Tanzania. Tanzania J Health Res. 2012;14(4):269-79.

Richards MA, Westcombe AM, Love SB, Littljohns P, Ramirez AS. Influence of delay on survival in patients with breast cancer: a systematic review. Lancet. 1999;353:111-926.

Facione NC, Miaskowski C, Dodd MJ, Paul SM. The self-reported likelihood of patient delay in Breast cancer: New thoughts for early detection. Prevent Med. 2002;34:397-407.

Anyanwu SN, Egwuonwu OA, Ihekwoaba EC. Acceptance and adherence to treatment among breast cancer patients in Eastern Nigeria. Breast. 2011;20:S51-3.

Ibrahimu NA, Popoola AO, Oludara MA, Omodele FO, Fadeyibi IO. Breast cancer among urban Nigerian women: appraising presentation and the quality of care. Macedonian J Med Sci. 2012;4:388-92.

Kun-pin H, Li-Chia C, Kwok-Leung C, Yi-Hsin Y. Risks of non-adherence to hormone therapy in Asia Women with breast cancer. Kaohsiung J Med Sci. 2015;31(6):328-34.

Gakwaya A, Kigula-Mugambe J, Kavuma A, Luwaga A, Fualal J, Jombwe J, et al. Cancer of the breast: 5-year survival in a tertiary hospital in Uganda. Br J Cancer. 2008;99:63-7.

Ayo MT, Julie Baron O, Ashley EW, Nancy JW, Luiza BG, Estabrook A, et al. Non-compliance with adjuvant radiation, chemotherapy and hormonal therapy in breast cancer patients. Am J Surg. 2008;196(4):500-4.

Ngadda HA, Yawe KD, Abdulazeez J, Khali MA. Breast Cancer Burden in Maiduguri, Northern Nigeria. Breast J. 2008;14(3):284-6.

Sule EA, Obaseki D. Pattern of histological types of breast cancer among various age groups in the Niger Delta. UNIBEN J Med Biomed Res. 2014;13(2):21-26.

Oguntola AS, Agodirin SO, Adeoti ML, Aderonmu AO. Bilateral Breast Cancer: Experience in a poor resource Black African setting. East and Cent Afr J Surg. 2010;15(1):28-34.

Temidayo OO, Omobolaji OA, Adeyinka FA, Adebamowo CA. Mastectomy for management of breast cancer in Ibadan Nigeria. BMC Surg. 2013;13(1):59.

Stephanie AS, Aaron Slinker, Deo Darius B, Katrina B Mitchell. Surgical management of breast cancer in Africa: A continent-wide review of intervention practices, barriers to care, and adjuvant therapy. J Global Oncol. 2017;3(2):162-8.