Jornal de Cuidados com a Saúde da Mulher
Acesso livre

Abstrato

Clinical Presentation, Prevalence and Management of Breast Cancer in Sokoto, Nigeria

Agbo PS, Khalid A and Oboirien M

Background: In recent times there have been increased cases of malignant breast diseases presenting to the surgical out - patient department of the Usmanu Danfodiyo university teaching hospital, Sokoto, Nigeria. The hospital receives referrals mainly from the neighboring state of Kebbi and occasionally from Zamfara. Unfortunately, majority of the patients present late with attendant poor outcome.
Objectives: To determine the clinical presentation, prevalence and management outcome of malignant breast diseases in Sokoto, Nigeria. Method: A retrospective review of case notes of all patients with histologically confirmed breast diseases between 2007 and 2011 was carried out. Data studied included demographic characteristics, stage at presentation, management and follow up. Results were analyzed using the windows SPSS Statistics 17.0.
Results: A total of 1822 patients were seen, out of which 816 (44.8%) had malignant breast disease and 1006 (55.2%) had benign disease. 288 women had breast cancer in 2011 (new and pre-existing cases) giving a prevalence rate of 10.4 cases per 100,000. The Male: Female ratio for breast cancer was 1: 203. The mean and modal age group for breast cancer was 41-50 years. Invasive ductal carcinoma was responsible for 800 (98%) of cases seen. Invasive lobular carcinoma followed with 12 (1.5%) cases. 452 (55.4%) patients presented with stage 3C (T4B, N3, M0) disease while 359 (44.0%) patients presented with stage 4 (T4C, N3, M1) disease. Only 5 (0.6%) patients presented with stage 2B (T3A, N1B, M0) disease. No patient was seen with stage 1 disease during the five year study period. Modified radical mastectomy was offered to 414 (50.7%) patients, while 200 (24.5%) patients had toilet mastectomy. Immediate post-operative mortality was 0.8% (5 cases). However, 67 (8.2%) patients died before they were offered surgery. The overall mortality therefore was 9.0% (72 cases). Follow up studies showed that 402 (53.7%) patients were seen during the first year follow up, while 88(11.7%) patients were seen during the second year. No patient was seen in the third year of follow up.
Conclusion: The prevalence rate of breast cancer in Sokoto in 2011 was 10.4 per 100 000 women. Late presentation was the norm with 99.4% (811) presenting with advanced disease (TNM stages 3 and 4) and 0.6% (5) presenting with stage 2 disease. Breast cancer therefore continues to carry poor prognosis in this part of the country.