Metastatic breast cancer in a Nigerian tertiary hospital

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 20-81years with a mean age of 45.9 years. Only 3(6 of 202) were males. Twothirds 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