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

Surgical Inpatient Mortality in a Nigerian Tertiary Hospital

Background: There is paucity of literatures on audit of mortality in the surgical units of tertiary hospitals in the country. This has made the spectrum of mortality not to been known in some of the centers and therefore; there is a great disparity and dearth in apportioning health care services appropriately. Aim: The determination of the pattern of mortality in a surgical unit helps in planning; provision of quality surgical care and prioritizing of limited resources in developing countries. Methods: This is a retrospective study of all patients who died during admission into surgical wards of our hospital between 2007 and 2012. Data on demography and events leading to death were collected and analyzed from all surgical wards; the emergency unit; surgical outpatients; and theater records. Results: A total of 527 deaths occurred among the 8230 patients admitted during the 6-year period giving a mortality rate of 6.4%. Three hundred and forty-five (65.5%) were male; while 282 (34.5%) were females. The mortality rates in units were as follows: Burn and plastic (23.1%); general surgery (5.5%); neurosurgery (7.9%); urology (6.0%); orthopedics (3.8%); pediatric surgery (3.4%); and cardiothoracic surgery (11.9%). The yearly mortality rate were as follows; respectively: 2007 (7.1%); 2008 (6.0%); 2009 (4.5%); 2010 (6.5%); 2011 (7.2%); and 2012 (7.5%). About 84.6% of the patients died within 1 month on admission. The leading causes of mortality were trauma (41.8%) and cancer (32.4%). Most of the deaths (64.9%) occurred between 20- and 70-year-old. Conclusion: Trauma and cancer constitute a great deal of health burden in our region. Strong legislation and screenings with timely interventions are required