The effect of beliefs about breast cancer on stage and delay to presentation: results from a prospective study in urban South Africa

Background: The disparity in breast cancer survival in Africa is often linked to poor education and awareness leading to late diagnosis and subsequent reduced survival. This study was designed to explore the relationship of attitudes and beliefs held regarding breast cancer to the stage and delay to diagnosis in South Africa. This study provies an epidemiological analysis of the spectrum of disease and outcomes of primary amputation for diabetic foot sepsis in a regional rural hospital.Methods: Women attending an open-access breast unit over 14 months with newly-diagnosed breast cancer answered a survey regarding their fears and beliefs of breast cancer care. Questions addressed demographic, socioeconomic and educational factors linked to delay, and documented time taken to care. Odds ratio with 95% confidence intervals were calculated to identify factors associated with advanced stage at presentation and delay greater than six months. Results: Of the 233 participants the median (IQR) age was 56 years (46­65). The most common stage at presentation was Stage 3 (55%), with 30.5% presenting with T4 tumour at presentation. Most women believed cancer could be beaten (90.0%), and their families would support them (92.8%). They disagreed that cancer was a curse (93.8%), punishment (90.5%) or that alternative therapies or traditional healing would cure their cancer (75.3% and 85.5% respectively). On univariate analysis, age under 45 years and transport difficulties predicted advanced stage at presentation. No socio-economic factors or beliefs increased the risk of delay to presentation. Conclusion: Participants' beliefs about their new breast cancer were most commonly appropriate, and showed a low level of fatalism, in contrast to other studies in Africa. Whilst raising awareness may be important, efforts to increase awareness alone may not directly prevent the likelihood of late or advanced diagnosis in this population

Delay to diagnosis and breast cancer stage in an urban South African breast clinic

Background. Breast cancer is the most common cancer in women in many low- and middle-income countries, and often presents at an advanced stage that affects prognosis irrespective of the care available. Although patient-related delay is commonly cited, the reasons for delay and the relationship of delay to stage are still poorly documented, especially in Africa. Objectives. To identify where patient-related socioeconomic delays occur and how these relate to stage at presentation. Methods. Consecutive women with a new breast cancer diagnosis were prospectively invited to complete a questionnaire on their socioeconomic characteristics and ability to access care. Clinical stage at presentation was documented. Results. Over 14 months, 252 women completed the questionnaire (response rate 71.6%). Their median age was 55 years (interquartile range 44 - 65), with 26.5% aged <45 years. Stage at presentation was stage 1 in 15.5% of patients, stage 2 in 28.5% and stage 3 in 56.0%. Almost a third of the patients (30.4%) presented with a T4 tumour (6.1% inflammatory). Total delay in presenting to the breast clinic was significantly associated with locally advanced stage at presentation (p=0.021). Average delay differed between early stage (1.5 months) and locally advanced (2.5 months), and most delay occurred between acknowledging a breast symptom and seeking care. The least delay was between attending a health service and presenting at the open-access breast clinic, with 75.0% presenting within 1 month. Factors associated with delay were difficulties with transport, low level of education and fear of missing appointments due to work. Conclusions. Most women delayed in seeking breast care. Facilitating direct access to specialist breast clinics may reduce delays in presentation and improve time to diagnosis and care

Incidence of human cytomegalovirus in breast carcinoma tissues is associated with a higher expression of growth factor receptor-bound protein 2

Background: female mammary carcinoma is the second most common cancer incidence among women and the fifth most common leading cause of cancer death worldwide. Premenopausal young women are more frequently targeted by inflammatory breast cancer (IBC), which is the most lethal form of breast cancer. The human cytomegalovirus (HCMV) has been identified as one of the viral infection with a higher frequency in carcinoma tissues of IBC than in non-IBC. The adaptor protein growth factor receptor-bound protein 2 (Grb2), was found to be upregulated in HCMV-infected cells and play as crucial role in cancer progression. Objective: this study aimed to assess the expression level of Grb2 in carcinoma tissues of IBC and non-IBC with HCMV infection. Patients and Methods: overall, 135 female diagnosed with breast carcinoma were enrolled in this study. Using conventional and real time polymerase chain reaction (PCR), we determined the incidence of HCMV and assessed the expression level of Grb2 mRNA in the breast cancer tissue samples. Results: Grb2 mRNA was significantly upregulated in HCMV+ IBC higher than in HCMV+ non-IBC. According to the molecular subtype, Grb2 mRNA was significantly higher upregulated in breast carcinoma tissues of HCMV+ hormonal positive (HP) than in triple negative (TN) counterparts. Conclusion: HCMV infection is associated with a high expression of Grb2 mRNA in IBC and that HP HCMV+ mammary carcinoma tissues confer upregulated Grb2 mRNA, suggesting a potential role of HCMV infection in enhancing of Grb2 mRNA expression in breast cancer with HP

Role of breast magnetic resonance imaging in early stage breast cancer

Background: globally, breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in women. The surgical management of patients with early stage operable breast cancer is the main step of treatment and addresses both the primary tumor and regional lymphatics. Objectives: this study aims at highlighting the role of preoperative dynamic contrast enhanced breast MRI in early stage breast cancer and its impact on surgical management. Patients and Methods: this study was carried out over the period from March 2015 to October 2017 in Radiodiagnosis Department of Mansoura University Hospitals and Nasser Institute. The study was conducted on 29 female their ages ranging from 30 to 59 years old the study was approved by our Institution's Ethics Committee, and all patients gave their informed consent before inclusion in the study. Results: in our study, MRI was requested for different causes varying between dense breast which may obscure lesions (51.7%), multifocal lobular carcinoma (13.7%), exclude multicentric lesion (10. 3%) and in (24%) of patients MRI was requested as preoperative routine check. In our study, we found that in 10 patients (34.5%), MRI revealed additional lesions that were not seen on conventional imaging by mammography and ultrasound.Six lesions (20.7%) of those additional occult lesions were identified as malignant and all were ipsilateral. Our study reported that six patients (20. 7%) who had unsuspected abnormalities identified on MRI had changes in treatment based on MRI findings. Conclusion: the results of this study confirm previous reports that preoperative MRI of the breast alters clinical management and detects otherwise occult carcinoma in a substantial number of patients with early breast cancer

Cancer du sein : immunohistochimie et pronostic au CHU Gabriel Touré de Bamako-Mali

Le sein est le deuxième siège du cancer chez la femme au Mali. Les examens immunohistochimiques sont peu réalisés dans nos pays africains. Objectifs: Décrire l'aspect immunohistochimique et déterminer le pronostic du cancer du sein. Méthodologie : C'est une étude descriptive à collecte rétrospective (mars 2006­juillet 2016) dans le service de chirurgie générale du CHU Gabriel TOURE de Bamako au Mali. L'examen immunoihistochimique a été réalisé chez tous les malades grâce à la collaboration de nos partenaires allemands. Résultats: Nous avons colligé 98 malades (95 femmes et 3 hommes) avec un âge moyen de 40,04 ± 13,07 ans. Vingt-deux malades (22,44 %) avaient un antécédent personnel de pathologie bénigne du sein. Chez 16 malades (16,33 %), il y avait une notion familiale de cancer du sein. La prise d'œtroprogestatifs a été évoquée chez 28 femmes (28,57%). Les types histologiques les plus fréquents étaient le carcinome canalaire infiltrant avec 84 (85,72%) et le carcinome lobulaire infiltrant dans 9 cas (9,18%). L'immunohistochimie a permis de trouver une prédominance du triple négatif avec quarante neuf malades (50%) suivi du sous type Luminal A avec 26 cas (26,23%).Selon la classification TNM, 44 patients (44,90 %) ont été reçus au stade III. La médiane de survie a été de 60 mois dans le groupe des patients ayant bénéficié d'une hormonothérapie versus 28 mois pour le groupe sans hormonothérapie (p=0.007). Conclusion: l'immunohistochimie est essentielle pour la prise en charge adéquate des cancers du sein. Sa réalisation nous a permis d'améliorer le pronostic des cancers hormono dépendant

Profil mammo-échographique et histopathologique des cancers du sein de la femme à Ouagadougou (Burkina Faso)

Objectif : Décrire les aspects radiologiques et histopathologiques des tumeurs malignes mammaires chez la femme au Burkina Faso. Matériels et méthodes : étude transversale analytique à collecte rétrospective réalisée de janvier 2014 à octobre 2017. Les patientes incluses ont eu une microbiopsie mammaire sous guidage échographique après une exploration mammographique et échographique, avec un résultat histopathologique de malignité. Les variables recueillies étaient l'âge, les antécédents, la taille des nodules, la classification ACR et le diagnostic anatomopathologique. Résultats : l'échantillon de lésions malignes étaient constitué de 173 nodules. L'âge moyen était de 49.15 ± 11.55 ans et la taille moyenne des lésions de 31.57 ± 18.21mm. Les femmes de moins de 40 ans représentaient 16,8% de l'échantillon. Les antécédents familiaux étaient connus dans 7% des cas. A l'imagerie, on notait 4,05% de lésions classées ACR3, 68,79% de lésions ACR4 et 27,17% de nodules ACR5. Les tumeurs malignes étaient constituées essentiellement de carcinomes canalaires infiltrants dans 98,26 %. Conclusion. Le cancer du sein est mis en évidence chez la femme de la cinquantaine. Les nodules ont une tendance à la bénignité chez les femmes jeunes. La taille moyenne de la lésion est importante au moment du diagnostic

Breast Imaging Reporting and Data Systems category 3 (probably benign) breast lesions detected on diagnostic breast ultrasound: The prevalence, outcome and malignancy detection rate in Zaria, Nigeria

Background: Probably benign breast lesions in the Breast Imaging Reporting and Data Systems (BI-RADS 3) constitute a crucial category and a considerable number of all palpable breast masses. Local data concerning the outcome of such lesions in the Nigerian environment is almost non-existent. Objectives: The goal of this article is to report the frequency, outcome and malignancy detection rate among palpable breast masses that were categorised on ultrasound as BI-RADS category 3 (probably benign) according to the American College of Radiology (ACR). Methods: Between January 2015 and July 2017, 603 patients had diagnostic whole-breast ultrasound scans. There were 277 women who complained of palpable breast masses, of whom 151 women were diagnosed as having BI-RADS 3 lesions. The final lesion outcome was determined by either biopsy or ultrasound follow-up examination for a total of 2 years. All data were recorded and analysed with Statistical Package for the Social Sciences (SPSS) version 20 (Chicago, USA). Results: The frequency of BI-RADS category 3 lesions among all the women who underwent breast ultrasound was 25% (151/603); and 54% (151/277) in patients with palpable breast masses. There were 25 patients who were excluded because of incomplete data or who were lost to follow-up. A total of 122 patients had both ultrasound examination and histopathologic diagnosis, while only 4 were followed up for 2 years on ultrasound alone. Of the 122 women biopsied, 117 (95.9%) had benign histologic outcomes, and of the remaining 5, cancer was confirmed in 2 (1.6%), while the remaining 3 patients (2.5%) had lesions considered intermediate at histology (juvenile papillomatosis, borderline phylloides and atypical ductal hyperplasia). Three out of four patients who had ultrasound follow-up alone had stable lesions after 2 years, while one patient had complete resolution. Conclusion: This study found a significantly high biopsy rate of 80% (122/151) for probably benign lesions but a low detection rate for malignancy (1.6%). Follow-up with imaging rather than biopsy for lesions sonographically described as probably benign, will reduce medical costs and unwarranted invasive procedures

Sarcomes du sein. Etude rétrospective à propos de 12 cas et revue de la littérature

Introduction : les sarcomes du sein sont des tumeurs malignes rares qui se développent aux dépens du tissu mésenchymateux mammaire. Ils constituent un groupe très hétérogène de néoplasie mammaire dont le point commun reste la différenciation tissulaire conjonctive. Ils représentent environ 1% de l'ensemble de néoplasies mammaires et moins de 5% de tous les cancers des tissus mous de l'organisme. Leur diagnostic est anatomo-pathologique. Le but de notre travail était d'analyser les aspects épidémiologiques, cliniques, paracliniques, thérapeutiques et évolutifs de ces tumeurs et de confronter nos résultats à ceux de la littérature. Méthodologie : Il s'agit d'une étude rétrospective descriptive réalisée sur une période de dix(10) ans (du 1er Janvier 2007 au 31 Décembre 2016). L'étude a concerné tous les patients de deux sexes, quel que soit l'âge, atteints de sarcome mammaire et ayant une preuve histologique pendant la période de notre étude. Résultats : au terme de notre enquête, nous avons colligé douze(12) cas. Notre fréquence globale était de 1,25%. Il s'agissait de onze(11) femmes et d'un homme d'âge moyen de 32,58 ans avec des extrêmes de 18 et 45 ans. Les 3 /4 avaient un âge inférieur à 40 ans, 45,5% de nos patientes étaient nullipares, et une seule était ménopausée au moment du diagnostic. Deux(2) avaient pris de contraception orale. 41,7% de nos patientes avaient un ATCD personnel de pathologie tumorale mammaire bénigne : une pour tumeur phyllode, deux(2) pour adénofibrome et deux(2) pour nodule sans précision de la nature histologique. On note aussi un ATCD familial au 1er degré de mastopathie non documentée chez deux patientes (16,67%). Le délai moyen de consultation était de sept(7) mois et tous les patients avaient consulté pour nodule mammaire. La taille tumorale moyenne était de 9,07 cm, avec une localisation au niveau du sein droit dans 58,33%. La présence d'adénopathie axillaire a été notée chez 25% de nos patients avec un seul envahissement ganglionnaire à l'histologie. L'imagerie a été peu contributive, la cytologie mettait en évidence soit des lésions bénignes, soit des lésions carcinomateuses sans précision du type histologique. Le diagnostic positif n'a été définitivement posé qu'à l'étude histologique. Les tumeurs se répartissent en sarcomes phyllode dans 5 cas (41,7%), 4 cas de liposarcome (33,1%), 2 cas de fibrosarcome (16,7%), et un cas de dermatofibrosarcome (8,3%). Le bilan d'extension initial était négatif dans tous les 12 cas. Tous les patients avaient bénéficié d'une chirurgie dans leurs séquences thérapeutiques : tumorectomie dans 5 cas (41,67%) et mastectomie dans 7 cas (58,33%), dont trois avec en plus un curage axillaire homolatéral. Les limites d'exérèses étaient précisées dans seulement 3 cas et étaient envahies dans tous les cas. Une seule patiente avait reçu une radiothérapie adjuvante et 3 une chimiothérapie adjuvante dont une seule en pré et post opératoire. Quatre de nos patients ont présenté une récidive locale et dans tous les cas après une tumorectomie. Trois ont développé des métastases pulmonaires et sont décédées ; et une autre était décédée de cause inconnue. Quatre patients étaient perdus de vue après le diagnostic. Trois de nos patients sont en rémission complète avec des reculs de 5 ans, 3ans, et 1 an respectivement. Conclusion : les sarcomes mammaires sont rares, représentant environ 1% des cancers mammaires. Ils constituent un groupe à part de néoplasie mammaire, atteignant surtout les femmes jeunes en période d'activité génitale. La rareté de ces tumeurs et leur hétérogénéité histologique rendent difficile leur diagnostic ; compromettant ainsi leur prise en charge précoce d'où leur pronostic en général péjoratif

Metastatic skin nodules in breast cancer: a report of five cases

Background: Breast cancer is the most common cause of cancer related death in female patients admitted in surgical wards of tertiary hospitals. It is common in elderly women and now being reported even in younger patients. Despite enlightenment campaigns patients still present with very late disease. Aim: This is to report five cases of metastatic skin nodules in breast cancer; an auditing tool of the breast cancer awareness campaign. Case Report: The first was a 55-year-old female who presented with a history of generalized skin nodules and progressive weight loss. She was pale and cachectic. Her pulse rate was 110 per minute and blood pressure was 90/50 mmHg. The second was 60-year-old female who presented with right breast lump and and multiple anterior chest wall nodules. The third was a 35-year-old female who presented with a left breast lump. She had excision biopsy and was lost on follow up The fourth case was 48-year-old female who presented with left breast ulcer and multiple anterior chest wall nodules. Lastly, the fifth was a 58-year-old female who presented with left breast ulcer, skin nodules and paraplegia. All cases had metastatic nodules found on the examination at presentation. Biopsy of these nodules confirmed infiltrating ductal carcinoma. Three died while receiving treatment while two were lost on follow-up.Conclusion: Death arising from metastatic cutaneous breast cancer is a good index for surgical audit. The findings of these cases in our environment depict need for more effort in awareness campaign for reducing mortality from breast cancer

How long are Elderly Patients Followed up with Mammography after the Diagnosis of Breast Cancer? A Single-Centre Experience in a Developing Country

BACKGROUND:The effect of breast cancer on elderly South African (SA) patients is not well characterised. The lack of data with regard to disease burden; post-treatment surveillance and breast cancer relapse poses a challenge to providing optimum follow-up care to this group of patients. OBJECTIVES:To assess the effect of breast cancer and adherence to post-treatment surveillance programmes among the local elderly population attending the breast oncology clinics at Addington and Inkosi Albert Luthuli Central hospitals in Durban; KwaZulu-Natal; SA.METHODS: A retrospective review was undertaken of all patients aged =65 years diagnosed with breast cancer during 2007. Hospital records were reviewed for a period of 5 years to ascertain the stage of the disease; treatment received; adherence to post-treatment surveillance mammograms; incidence of new mammographic findings and recurrence; site of recurrence; mode of detection of recurrence; disease-free survival; and overall survival rates at 5 years.RESULTS:In our study; the incidence of breast cancer in the elderly population was 26.7%. A significant percentage of patients (56.3%) were diagnosed at an advanced stage of disease. Of the 46.9% who had received surveillance mammography; only 6.3% received their post-treatment surveillance mammograms on time; in accordance with international recommendations. New mammographic findings were detected in 26.7% of patients during the 5-year follow-up. During the follow-up period; 15.6% of the total number of study patients presented with disease recurrence. Eighty percent of cases of recurrence were detected clinically. The overall survival at 5 years was 65.6%. CONCLUSION:Our study highlights the significant number of elderly patients with advanced disease at diagnosis; poor compliance with internationally recommended annual post-treatment surveillance mammograms; and the relatively low overall 5-year survival rate compared with that of international studies

Breast Cancer Screening in a Resource Poor Setting: A Preliminary Report

Background: Breast cancer is a leading cause of death among Nigerian women. Patients typically present late with advanced and aggressive diseases from a younger age. Cure for breast cancer is only possible when the disease is discovered early and breast cancer screening greatly increases the chances of early detection. We present the results of a breast cancer screening program at the Taimako Breast and Cervical Cancer Screening Centre; Lafia; Nigeria. Methodology: This is a prospective study of subjects who presented to our breast cancer screening centre between May 2009 and April 2010. A community mobilization and awareness campaign was mounted 3 months before screening began. A structured questionnaire was administered on each subject to elicit demographic data and risk factors. Each had a clinical breast examination. Those 35 years and above had a mammography while those below 35 years had breast ultrasound scan. Where a lump was discovered; it was subjected to tissue biopsy and histology. Results: Two thousand and ninety five subjects were seen over the one year period. Mean age was 34 + 12 years. Mean age at menarche was at 14.3 + 1.7 years; mean parity was 3.6 +2.6. Two thousand and thirty six subjects (97.2) had some knowledge about breast cancer; 1;269 (60.5) had no formal education; 881(42.1) were petty traders while 501(23.9) were full time housewives. Four hundred and seventy (22.4) had a positive family history of breast disease; 437 (20.9) had history of use of oral contraceptives; and 9 (0.4) had a previous breast biopsy. Four hundred and sixty one (22.0) complained of breast discomfort; 184 (8.8) complained of breast lumps; but only 95 (4.6) of them had lump on clinical breast examination; while a further 8 (0.4) lumps were found on breast imaging. One thousand nine hundred (90.7) had normal breast screening results; 166 (7.9) had benign breast diseases and 29 (1.4) had breast cancer. Conclusion: Knowledge about breast cancer was high because of prior campaigns and should be encouraged. Proportion of subjects with breast cancer is low even though many complained of breast lumps on presentation. Majority of the lumps were found at clinical breast examination while mammogram had a very low yield. A treatment arm needs to be incorporated into the screening program to demonstrate survival benefit

Histopathological review of breast tumours in children and adolescents in Delta State Nigeria

Background: Breast swellings in children and adolescents may be overlooked on assumption that they are physiological enlargement. Pathologic swellings including cancers have however been encountered in this age group. This study highlighted the spectrum of tumours in childhood and adolescents. Materials and Methods: This was a 7 year retrospective analysis of all histologically diagnosed breast tumours in people aged 0 - 19 years. Results: There were 134 breast tumour diagnoses occurring in 133 females and 1 male (gynaecomastia). One hundred and nineteen cases (88.8) were recorded in the 10 - 14 year age group and 15 cases (11.2) in the 15 - 19 year age group. No case was found in children aged less than 10 years. The most common tumour was fibroadenoma accounting for 75.4 (n = 101) of all tumours followed by tubular adenoma (n = 11; 8.2) and adenosis (n = 10; 7.4). No case of malignancy was recorded in this study. Conclusion: Fibroadenoma is the most common breast tumour in children and adolescents in our environment

Breast Carcinoma in a 7-Years- Old Girl

This is a case report of a 7 years old female patient diagnosed to have secretory carcinoma of the breast and secondary axillary lymph nodes metastasis after she presented with compliant of left breast swelling that lasted for about 6 months. It is a rare ( 1) type of breast carcinoma with distinct histologic features. Diagnosis of this carcinoma at fine needle aspiration cytology (FNAC) is quite difficult and it is not a particularly aggressive tumor with excellent prognosis even in the presence of metastasis. Axillary locoregional lymph node metastases are uncommon. Several authors; therefore; recommend a conservative and non-aggressive treatment as much as possible. In her case; modified radical mastectomy with level II axillary dissection was done without hormonal or chemotherapy. So far; the therapeutic approach tends to be fairly flexible

Knowledge; Attitudes; Beliefs; Behaviour and Breast Cancer Screening Practices in Ghana; West Africa

Background: Late presentation has been observed as the hallmark of breast cancer in Ghanaian women where over 60 of patients report with either stage 3 or 4 of the disease. This cross-sectional study aimed at exploring breast cancer related knowledge and practices in order to develop an appropriate socio-economic and cultural specific model to improve breast cancer care in Ghana. Methods: The study which was conducted in Accra and Sunyani in Ghana used both quantitative and qualitative methods and employed the theory of planned behavior as a communication and educational model. Information was collected from 474 women using questionnaires. In addition semi-structured interviews were conducted on 10 breast cancer patients; 10 breast clinic attendants; 3 Oncology Consultants and 2 herbalists. Results: Generally; the respondents displayed knowledge deficit about the disease. However; higher levels of education was associated with better appreciation of the disease (rs =0.316; N= 465; p 0.001). The respondents' attitudes include fear of the disease which was linked to death in most cases; denial and guilt; as well as supernatural attributes. The self-reported breast cancer screening rate (BSE 32; CBE 12 and mammogram 2) was poor; however; higher educational of the respondents was very significant for breast cancer screening practices. Conclusion: The study found that routine mammography screening is not feasible in Ghana at the moment which therefore requires a different approach

Breast Cancer Knowledge and Awareness among University Students in Angola

BACKGROUND:The high breast cancer mortality rate in Sub-Saharan Africa has been attributed to a lack of public awareness of the disease which often leads to late diagnosis of the disease. Little is known about the level of knowledge and awareness of breast cancer in Angola. Previous studies have shown that breast cancer awareness is higher among well-educated people. The goal of this study was to assess breast cancer knowledge and awareness among university students in Angola.METHODS: We conducted a cross-sectional survey of university students using a self-administered questionnaire to investigate participants' awareness and knowledge of breast cancer. A total of 595 university students in medical and non-medical programs successfully completed the survey. RESULTS: Our results showed insufficient knowledge of breast cancer among university students in Angola irrespective of whether they were in medical or non-medical programs. The majority of the participants were not aware of some of the early signs of breast cancer such as change in color or shape of the nipple; even though they appreciated the need for monthly breast self-examination. Overall most of the participants indicated the need for increased breast cancer awareness among university students.CONCLUSION: The study points to the insufficient knowledge of university students in Angola about breast cancer. We expect that our results may provide useful data that may be used by the department of health in Angola and other African countries to formulate health education programs aimed at increasing awareness and promote screening and early detection of breast cancer in the continent

Collaboration oncologue radiologue et pathologiste dans la détermination pré thérapeutique des récepteurs hormonaux et de HER2 dans les cancers du sein inopérables d'emblée en Côte d'Ivoire. Résultats préliminaires

Contexte : Le cancer du sein en Afrique subsaharienne et en Côte d'Ivoire en particulier est caractérisé par les stades avancés au diagnostic, rendant la plupart des tumeurs inopérables d'emblée. La microbiopsie n'étant pas pratiquée, le plateau technique d'immunohistochimie n'existant pas, les patientes atteintes de cancer du sein ne bénéficiaient jusque là que d'une cytoponction. Il était alors impossible d'avoir en préthérapeutique leur statut histologique et moléculaire. Pour y remédier, une collaboration interdisciplinaire a débuté entre oncologues, radiologues et pathologistes.Objectif : Déterminer le profil préthérapeutique des récepteurs hormonaux et de HER2 chez les patientes non opérables d'emblée.Patientes et méthodes : Une étude prospective, descriptive, sur 12 mois, a été réalisée au service de Cancérologie du CHU de Treichville à Abidjan (Côte d'Ivoire). Les résultats préliminaires ont porté sur 19 patientes atteintes de cancer du sein localement avancé, inopérable d'emblée ayant toutes bénéficié d'une microbiopsie échoguidée.Résultats : L'âge moyen de nos patientes était de 47 ans. Le délai moyen de consultation était de 10 mois. Huit patientes sur 17 étaient RH + dont une seule patiente ménopausée, 8 patientes sur 17 étaient HER2+ dont 2 ont nécessité une confirmation par le test de FISH.Conclusion : Cette pratique des biopsies percutanées préthérapeutiques devrait progressivement pouvoir remplacer la cytoponction afin de connaitre le statut des récepteurs hormonaux et de HER2 et ainsi améliorer la prise en charge des patientes

Breast Fine Needle Aspiration Cytology in a Nigerian Tertiary Hospital

Objectives:Breast disease remains a major public health issue worldwide.It is the most common cancer among Nigerian women.Fine needle aspiration cytology (FNAC) is an important preoperative assessment tool along with clinical and mammography examination in both screen detected and symptomatic breast disease.This study provide opportunity to determining the accuracy of FNAC and factors affecting false negative rate in Obafemi Awolowo University Teaching Hospital complex; Ile-Ife; Osun state Nigeria Method:All patients seen in the breast clinic with lump were sent to the pathology department for FNAC from January 1997 to December 2004.The sociodemographic data; cytology result; final histology result and the clinical staging for breast cancer were analyzed.Results:Eight hundred and sixty-four patients had FNAC during the studied period; however only 632 cases had available final histological report.Of these; 20 (3.2) were male while 612 (96.8) were female; the age ranged from 15 years to 99 years; median of 36.50.We found that absolute sensitivity for malignancy to be 70.8.The false negative rate was 14.9; while the false positive rate was 1.8.The suspicious rate was 9.8while the inadequate rate was 5.4.Conclusion:FNAC remains the least invasive; the most rapid and the most cost effective method to confirm clinical and radiological suspicion of malignancy; however; the test has high false negative rate.We recommend that consultation between pathologists and the clinicians should be facilitated and encouraged to reduce the high false negative. Also; multi-disciplinary audits of difficult case should be part of the work routine

Three-Year Clinico-Pathological Observations of Breast Carcinoma in Okolobiri; Bayelsa State; Nigeria

Aim: To ascertain the clinico-pathological pattern of breast cancer at the Niger Delta University Teaching Hospital. Methods: This was a retrospective study of all BC patients treated from January 2007 to December 2009 in the Surgical Department of the Niger Delta University Teaching Hospital. Okolobiri; Bayelsa State; Nigeria. Relevant data including name; age; sex; history and examination findings and results of histopathology and other investigations were collected from case files of all the patients treated for BC during the period under review. The data was then analysed manually and by using stat-graphics version 2.3. Results: A total of 42 patients were included in the study and they were all females. Twelve patients (28.6) were of the 31-40 years age group; followed by 21-30 years age group with 10 patients (23.8). Thirty-one patients (73.8) between the ages of 21-50 years were premenopausal. The commonest histological type was infiltrating ductal carcinoma which was found in 23 (54.7) patients. Late presentation was seen in 38 (90.5) patients. The right breast was affected in 22 (52.4) cases; the left in 19 (45.2) and only one (2.4) was bilateral. Mortality was 4.8. Conclusion: Cancer of the breast is still a common problem presenting in the young to middle age groups. Infiltrating ductal carcinoma is the commonest variant. Late stage presentation is often the norm in this locality. There is the need to increase the awareness of the disease

Breast tumours of adolescents in an African population

Background: Tumours of the breast are uncommon in childhood and adolescence. Patients in this age group often require a different approach to diagnosis and treatment. The purpose of this study is to highlight the clinicopathologic features of breast tumours in adolescents in a Nigerian city. Materials and Methods: Eighty-four breast tumour materials from patients aged 10-19 years were analyzed over a 10-year period at the Department of Pathology; University of Benin Teaching Hospital (UBTH); Benin City; Edo State; Benin City; Nigeria. Results: A majority of the breast tumours were benign. Fibroadenoma was the most common tumour with 46 cases (54.8); followed by fibrocystic changes with 15 cases (17). Malignancy was extremely rare in this group; with only one case (1.2) of an invasive ductal carcinoma. Histologically; most tumours were indistinguishable from the adult types. Conclusion: Fibroadenoma is the most common breast tumour in adolescents in Benin City; Nigeria. Breast cancer and male breast tumours are rare in this age group. Routine complete physical examination of children and adolescents should include breast examination