Breast invasive carcinoma is the most cancer in the world. In low resource countries, cancer are of poor prognosis for they are diagnosed at later stage. There is not a cancer registry in the Democratic Republic of Congo and studies on biomarkers are lacking. This study had the main purpose to determine the expression of Ki-67 and the prognosis of invasive breast carcinoma in Congolese women. Cross-sectional study of 86 women with invasive Breast Carcinoma were included in the Democratic Republic of Congo from Kinshasa (n=73) and Lubumbashi Cities (n= 13). Age at the time of diagnosis, tumor size, tumor necrosis, grade of tumor and proliferation index measured by Ki-67 were taken into account. Statistical analysis used SPSS program and Pearson Chi-square test. From 2014 to 2016, biopsies were collected from 86 Congolese patients to determine the expression of Ki-67 and the prognosis of invasive breast carcinoma. The proliferation marker was observed in 91.9%. K-i67 > 20% and > 30% were found respectively in 55.8% and in 33.7% of patients. The value of the Ki-67 was influenced by the tumor stage. The association between the size of the tumor and Ki-67 was statistically significant. The risk of tumor necrosis was 2.9 times in case of tumor with positive Ki-67. Ki-67 was positive in many patients younger than 45 years. However, the difference was not statistically significant. In patients with T3 and T4 tumors, the risk of positive Ki-67 was 7 times compared to those of T1 and T2 tumors. Patients with G3 tumors had 9 times the risk to have positive Ki-67 compared to those with G1 and G2 tumors. In conclusion, tumors in Congolese women are associated with higher proliferation index and poor prognosis for most of them are diagnosed at later stage. Chemotherapy can be justified for prior care in low resource countries and radical mastectomy should be encouraged.
Introduction: Most cases of breast cancer occur in low-income countries. Breast cancer patients in resource-limited settings experience longer diagnostic delays, leading to later-stage presentations. The late discovery of breast cancer breast exposes the patient to longer treatment mutilating, longer, more expensive, with reduced chance of recovery. It is therefore important to promote early detection and diagnosis at the beginning stage to reduce morbidity and mortality. Patient and Method: our cross-sectional descriptive study was carried out over a period of 5 years (2015)(2016)(2017)(2018)(2019)(2020) in the surgery department of the university clinics of Lubumbashi. Its main objective was to describe the epidemiological, clinical and histological aspects of breast cancer breast at the University Clinics of Lubumbashi. Results: it emerges from this work that breast cancer represents 3.34% of all cancers collected during the study period. The number of breast cancers varied from 3 cases recorded in 2015 to 29 in 2020, with an average of 12 cases per year. The majority of them came from the Lubumbashi commune, i.e. 39% of cases. The age of the majority of patients was over 35 years old or 60% with an average of 41.59± 13.44 years. The average consultation time was 10.52± 7.12 months, the breast nodule was the revealing sign in most cases, i.e. 94%. The most important primary method of cancer detection was self-examination (59.72%). The most found risk factors were family history and breast density with 36% and 28% respectively. The tumor was located on the left in 65% of cases with the most important seat in the superoexternal quadrant (42%). The mean tumor size was 4.43±2.26 cm. The most found histological type was invasive ductal carcinoma with 90% of cases. Management was surgical and consisted of lumpectomy in the majority of cases (58.83%). Conclusion: breast cancer remains very common in Lubumbashi among women over 35 years old. Its diagnosis is often late, the average delay being 10.52±7.12 months. It is important to strengthen early detection measures in order to reduce mortality linked to late management.
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