Background:Breast cancer is now the commonest female malignancy worldwide. The prognosis of such depends on the histopathological type, biological behavior, stage at presentation, availability of adequate oncological services.Aims and Objectives:The aim of this this study is to evaluate the statistics and challenges of breast cancer management in the study centre and compare with other centres.Materials and Methods:This is a prospective, descriptive study that spanned over a period of 4 years (January 2015-December 2018). The study was carried out in the General surgery division of the Surgery Department of the Federal Medical Centre, Keffi.Results:A total of 199 patients were recruited into this study out of which 196 (98.25%) were females and 3 (1.5%) were males. Their age ranged between 20-60 years. The commonest histopathological variant diagnosed is invasive ductal carcinoma (NOS). Early presentation was seen in 54 (<30%) while 145 (>70%) patients had late clinical presentation.Conclusion:Diagnosing and managing breast cancers successfully are mitigated my myriads of factors. Public awareness and provision of adequate care facilities will improve overall survival.
BACKGROUND: The help-seeking interval and primary-care interval are points of delays in breast cancer presentation. To inform future intervention targeting early diagnosis of breast cancer, we described the contribution of each interval to the delay and the impact of delay on tumor progression. METHOD: We conducted a multicentered survey from June 2017 to May 2018 hypothesizing that most patients visited the first healthcare provider within 60 days of tumor detection. Inferential statistics were by t-test, chi-square test, and Wilcoxon-Signed Rank test at p-value 0.05 or 95% confidence limits. Time-to-event was by survival method. Multivariate analysis was by logistic regression. RESULTS: Respondents were females between 24 and 95 years (n=420). Most respondents visited FHP within 60 days of detecting symptoms (230 (60%, 95% CI 53-63). Most had long primary-care (237 of 377 (64% 95% CI 59-68) and detection-to-specialist (293 (73% (95% CI 68-77)) intervals. The primary care interval (median 106 days, IQR 13-337 ) was longer than the help-seeking interval ( median 42 days, IQR 7-150 ) Wilcoxon signed-rank test p= 0.001. There was a strong correlation between the length of primary care interval and the detection-to-specialist interval (r= 0.9, 95% CI 0.88- 0.92). Patronizing the hospital, receiving the correct advice, and having a big tumor (>5cm) were associated with short intervals. Tumors were detected early, but most became advanced before arriving at the specialist clinic. The difference in tumor size between detection and arriving at a specialist clinic was 5.0±4.9cm (95% CI 4.0-5.0). The hazard of progressing from early to locally advanced disease was least in the first 30 days (3%). The hazard was 31% in 90 days. CONCLUSION: Most respondents presented early to the first healthcare provider, but most arrived late at a specialist clinic. The primary care interval was longer than the help-seeking interval. Most tumors were early at detection but locally advanced before arriving in a specialist clinic. Interventions aiming to shorten the primary care interval will have the most impact on time to breast cancer presentation for specialist oncology care in Nigeria.
How to cite / Atıf için: Dada SA, Rafiu MO, Ganiyu A, Dada OE. Clinical and demographic characteristics of patients with kidney disease presenting at a tertiary hospital for expert care in southwest Nigeria.
BACKGROUND: The help-seeking interval or the primary-care interval are points of delays in breast cancer presentation. To inform future breast cancer down-staging intervention, we described the contribution of each interval to the delay and the impact of delay on tumor progression.METHOD: Multicentered survey from June 2017 to May 2018. We hypothesized that most patients visited the First Healthcare Provider within 60days of tumor detection. Inferential statistics were by t-test, chi-square test, and Wilcoxon-Signed Rank test at p-value 0.05 or 95% confidence limits. Time-to-event was by survival method. Multivariate analysis was by logistic regression.RESULTS: Respondents were females between 24 and 95 years (n=420). Most respondents visited FHP within 60 days of detecting symptoms (230 (60%, 95% CI 53-63). Most had long primary-care (237 of 377 (64% 95%CI 59-68) and detection-to-specialist (293 (73% (95% CI 68-77)) intervals. The primary care interval (median 106days) was longer than the help-seeking interval ( median 42days ) Wilcoxon signed-rank test p= 0.001. There was strong correlation between length of primary care interval and the detection-to-specialist interval (r= 0.9, 95% CI 0.88- 0.92). Patronizing the hospital, receiving the correct advice, and having a big tumor (>5cm) were associated with short intervals. Tumors were detected early, but most became advanced before arriving at the specialist clinic. The difference in tumor size between detection and arriving at a specialist clinic was 5.0±4.9cm (95% CI 4.0-5.0). The instantaneous hazard of progressing from early to locally advanced disease was least in the first 30 days(3%). The hazard was 31% in 90 days.CONCLUSION: Most respondents presented early to the first healthcare provider, but most arrived late at a specialist clinic. The primary care interval was longer than the help-seeking interval. Most tumors were early at detection but locally advanced before arriving in a specialist clinic. Interventions aiming to shorten the primary care interval will have the most impact on time to breast cancer presentation for specialist oncology care in Nigeria.
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