Bilateral Breast Cancer: Experience in a Poor Resource Black African Setting

Background: Breast cancer is the most common malignancy in women in Nigeria. Women previously treated for ipsilateral breast cancer have increased risk of developing contalateral breast cancer (CBC); the chance of which increases with longer period of survival and is associated with worse prognosis. Reports from Nigeria are few on this. The aim of this study was to assess the prevalence; predisposition; presentation; and outcome of management of bilateral breast cancer (BBC) in a population; South-western Nigeria.Methods: A review of bio-data of all patients with BBC seen in LTH; Osogbo; Nigeria between 2001 and 2008 was done. Age; parity; age at menarche and first child birth; family history; duration of symptoms; tumour characteristics and exposure to cigarette; oral contraceptive pills (O.C Pills) and outcome of treatment were also assessed.Results: BBC constituted 4.6of the 256 breast cancer patients. Eight (73) were metachronous and 91were infiltrating ductal carcinoma. Patients' mean age; mean age at menarche and first child birth were 39; 14.5+3 and 22.5yrs respectively. Mean parity was 3.5 child birth; 91were premenopausal and all have menstruated for 12-31yrs. None had positive family history while only 1 and 3 had insignificant exposure to cigarette and O.C pills respectively. The mean interval between the 2 onsets was 18mths (0-68mths). 91of all tumours were advance; while 81of the first tumours were on the right. Mean duration before presentation for the first and second tumours were 261 and 111 days respectively. One patient has survived for 2 years thus far.Conclusion: The incidence of BBC was 4.26. Most patients were young and premenopausal with mostly infiltrating ductal carcinoma (NOS) and presenting with late stage disease; hence poor prognosis. Aggressive follow-up of patients with ipsilateral cancer will aid early detection of CBC

Male breast cancer in LAUTECH Teaching Hospital Osogbo, South Western Nigeria.

AIM: To assess the prevalence, presentation, treatment and outcome of management of male breast cancer (MBC) in Osogbo, Nigeria. METHODS: A review of all cases of MBC seen at LAUTECH Teaching Hospital Osogbo between January 2004 and December 2006 was done. The age, presenting symptoms and signs, stage, histology, associated co-morbid illnesses, treatment and outcome of care were all retrieved and analysed. RESULTS: Seven (8.86%) out of seventy nine cases of breast cancers seen are males. Ages ranged between 38 and 80 years (mean 60.5 median 65 years). They all presented with advanced lesions after a 6 -36 months delay (mean-11.57 months). All were invasive ductal carcinoma. All the four with significant co-morbid illnesses died of them within one week to seven months. Only one patient had mastectomy. CONCLUSION: MBC constitutes 8.86% of all breast cancer, all presented late with advanced lesions and co-morbid illnesses contributed significantly to mortality.

A review of typhoid perforation in a rural African hospital.

In Wesley Guild Hospital Ilesa in the South-West region of Nigeria a retrospective study of 105 consecutive cases operated upon for typhoid perforation between January 1988 and November 2001 was carried out. The ages of the patients were between 4 to 70 years with a mean age of 19.2 +/- 8.81. There were 84 males (80%) and 21 females (20%) giving a ratio of 4:1. Diagnoses were based on clinical and radiological findings. All the patients had laparotomy after resuscitations with intravenous fluids, electrolytes replacement, broad spectrum antibiotics, Nasogastric intubation/suctioning and urethral catherterisation. There were five negative laparotomies (4.8%). Eighty patients (76.2%) had a single perforation, while the rest 20 had multiple perforations. The perforations were located between 7 cm and 100cm from the ileo-Caecal junction. Apart from the patients who had resection and primary anastomosis, 95 (90.5%) had 2 layered closure of the perforation. The most common complications were wound infections (26.7%). Intra-abdominal abscesses (9.5%) and would dehiscence (7.6%). The mortality rate was 16.2% showing a remarkable improvement in the West African Subregions.