Metastatic breast cancer in a Nigerian tertiary hospital

Afr Health Sci. 2011 Jun;11(2):279-84.

Abstract

Background: Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome.

Objective: To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital.

Method: Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were reviewed.

Results: More than half of all histologically confirmed breast cancer patients seen within the study period presented with metastatic disease. Their ages ranged between 20-81 years with a mean age of 45.9 years. Only 3% (6 of 202) were males. Two-thirds had more than one secondary site on initial evaluation and the commonest sites were liver (63%), lung parenchyma (51%), pleura (26%) and contralateral breast in 25%. On immunohistochemistry, basal like tumours were found in 46.1%. Mastectomy was done in 37 patients with fungating breast masses while only one third of those referred to a nearby center for radiotherapy had it done. One year survival rate was 27%.

Conclusion: Metastatic disease is common in Nigeria and treatment is limited due to resource limitations. Improved awareness of the disease is advocated to reduce late presentation.

Keywords: breast cancer; developing country; metastasis.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / classification
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy*
  • Combined Modality Therapy*
  • Delayed Diagnosis
  • Female
  • Follow-Up Studies
  • Hospitals, Teaching
  • Humans
  • Male
  • Mastectomy
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Basal Cell / classification
  • Neoplasms, Basal Cell / epidemiology
  • Neoplasms, Basal Cell / pathology*
  • Neoplasms, Basal Cell / therapy*
  • Nigeria / epidemiology
  • Radiotherapy
  • Sex Distribution
  • Socioeconomic Factors
  • Treatment Outcome
  • Young Adult