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Conservative breast management of breast cancer in the Niger Delta; early report of nine cases
Abstract
Background: Conservative breast management (CBM) has become the standard of care for early breast cancer especially in developed countries. However it’s utilization in Nigeria, a developing country is greatly limited even in early cases despite international clinical trials confirming equivalent survivals for CBM and mastectomy.
Setting: Central hospital Warri, Delta state university teaching hospital.
Nature of Study: Descriptive
Subjects: Nine cases of early breast cancer from thirty seven breast cancer cases seen in the Authors practice from 2004 to 2011.
Clinical Findings: The patients ages ranged between 28-43 years, mean 36.8years. Reported duration of breast lump ranged between 3-18 months, mean 6.6 months. Tumour size ranged between 0.5-8cm, mean size 4cm. There was clinical axillary involvement in six cases. None showed clinical evidence of systemic dissemination. Histology showed invasive ductal carcinoma in six cases, one case of ductal carcinoma-in-situ and two cases of invasive lobular carcinoma. Negative margins were confirmed histologically in seven cases. Two re-excisions were required in three cases, one re-excision in two cases. One case undergoing conserving breast surgery opted for a mastectomy with mastectomy specimen showing no evidence of tumour. Anthracycline based chemotherapy adjuvant with sequential taxane therapy in some cases was valuable in achieving negative margins. Radiotherapy has been administered in seven cases with two cases on cue for radiotherapy. Local recurrence or systemic dissemination has not been noted in all the cases at 7 months to 7 years post diagnosis duration, mean duration 3.2 years.
Conclusion: Despite hurdles encountered in managing breast cancer in a developing country, conservative breast management for early stage breast cancer can be successfully utilized in a developing country.
Setting: Central hospital Warri, Delta state university teaching hospital.
Nature of Study: Descriptive
Subjects: Nine cases of early breast cancer from thirty seven breast cancer cases seen in the Authors practice from 2004 to 2011.
Clinical Findings: The patients ages ranged between 28-43 years, mean 36.8years. Reported duration of breast lump ranged between 3-18 months, mean 6.6 months. Tumour size ranged between 0.5-8cm, mean size 4cm. There was clinical axillary involvement in six cases. None showed clinical evidence of systemic dissemination. Histology showed invasive ductal carcinoma in six cases, one case of ductal carcinoma-in-situ and two cases of invasive lobular carcinoma. Negative margins were confirmed histologically in seven cases. Two re-excisions were required in three cases, one re-excision in two cases. One case undergoing conserving breast surgery opted for a mastectomy with mastectomy specimen showing no evidence of tumour. Anthracycline based chemotherapy adjuvant with sequential taxane therapy in some cases was valuable in achieving negative margins. Radiotherapy has been administered in seven cases with two cases on cue for radiotherapy. Local recurrence or systemic dissemination has not been noted in all the cases at 7 months to 7 years post diagnosis duration, mean duration 3.2 years.
Conclusion: Despite hurdles encountered in managing breast cancer in a developing country, conservative breast management for early stage breast cancer can be successfully utilized in a developing country.
