Axillary nodal metastasis and resection margins as predictors of Loco Regional Recurrence in Breast Cancer Patients.

Background: Surgical resection margins (RM), axillary nodal involvement and lymph node ratio (LNR) determine loco-regional control (LRC) in breast cancer management. Late presentation precludes breast conservation therefore surgical option is usually mastectomy and adjuvant chemoradiation minimize loco-regional recurrence (LRR). Objective: We investigated the prognostic role of lymph nodes positive for malignancy (pN), LNR and RM on LRR of breast cancer in a tertiary hospital in Ibadan, Nigeria. Methods: Longitudinal cohort study of 225 females with breast carcinoma managed and followed up for 5-years with end point of LRR or not. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with LRR. The receiver-operator curve was plotted to determine the proportion of metastatic lymph nodes which predicted LRR. Results: Ninety-nine percent had modified radical mastectomy and 163 (72.4%) had negative resection margins. A mean of 11 axillary lymph nodes were harvested at surgery. The age, positive resection margin and number of harvested nodes with malignant cells are associated with LRR. The overall 5-year LRR rate was 16%. Conclusion: LRR is dependent on lymph node involvement as well as and tumor aggressiveness.

Attitudes towards abortion law reforms in Nigeria and factors influencing its social acceptance among female undergraduates in a Nigerian university.

BACKGROUND: Unsafe abortion is one of the causes of maternal morbidity and mortality globally and it is still a burden in Nigeria. Restriction laws have been blamed for the recurrent vulnerability of women including female adolescents to unsafe abortions. METHODS: A cross-sectional, semi-structured, self-administered questionnaire was administered to 407 first year female undergraduates in the three female halls of residence of the University of Ibadan, Nigeria in February 2012 to determine their attitudes to abortion laws and the social acceptance of abortion laws in Nigeria. RESULTS: A vast majority (96.1%) knew what an abortion was and barely half were aware of the grounds in which it may be legal. Only 84 (20.6%) of the respondents knew that there were 2 abortion laws in operation in Nigeria. One hundred and thirteen (27.8%) wanted the current abortion law to be reformed and thirteen (3.2%) admitted that they had had an abortion in the past. More than half of them, 212 (52.1%) would support an abortion if pregnancy followed rape/ incest and 201(49.4%) if there was fetal abnormality. Religious reasons influenced the social opinions on abortion laws in most of the students (73%). CONCLUSION: The study showed some awareness towards abortion law reforms and we advocate that sexually active young individuals should be encouraged to adopt effective dual protection against unwanted pregnancy and STIs. Efforts should also be made at imparting reproductive health education to youths, especially girls.