A national framework for breast cancer control: A report on Rwanda’s inaugural symposium on the management of breast cancer

Murthy, Samskruthi; Tapela, Neo; Muhimpundu, Marie Aimée; Balinda, Jean Paul; Musabyemariya, Florence; Kirby, Katie; Pace, Lydia E.; Riviello, Robert; Ntirenganya, Faustin; Ntakiyiruta, Georges

doi:10.1016/j.jcpo.2015.08.004

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…Indeed, the majority of patients with breast cancer in Rwanda and in sub-Saharan Africa may be young premeno-pausal women, presenting with advanced stages of the disease and having poor outcomes [6,8,[13][14][15]. The reasons why it happens like that are not yet fully understood.…”

Section: Discussionmentioning

confidence: 99%

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Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study

Ntirenganya

Twagirumukiza

Bucyibaruta

et al. 2021

International Journal of Breast Cancer

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Background. Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women’s cancer-related deaths and morbidity worldwide. In Rwanda, BC incidence is increasing with an unacceptably high mortality rate in premenopausal women. Objectives. The purpose was to identify modifiable BC risk factors and assess associations between common breast cancer risks factors and molecular subtypes in premenopausal women in Rwanda. Methods. This was a case-control study. Premenopausal women with histological confirmation of BC and frequency-matched for age controls were recruited. A preestablished questionnaire was administered to both cases and controls for sociodemographics, BC probable risk factors, and clinical and pathological characteristics. BC was classified into luminal A, luminal B, HER2-type, basal-like (triple negative), and unclassified molecular subtypes by immunohistochemistry (IHC). Odds ratio (OR) and 95% confidence interval (CI) were estimated using multivariate logistic regression analysis. Results. 340 participants were recruited into the study (170 cases vs. 170 controls). The median age was 39 years. The majority of cases presented at advanced stages of the disease (51.2% in stages III and IV) and had invasive ductal carcinoma (98.2%). 60.6% had subtypes of poor prognosis (HER2 enriched 14.7%, triple negative 12.9%, and unclassified 32.9%). Alcohol intake AOR = 3.73 , 95 % C I 2.19 − 6.32 , p < 0.001 , obesity/overweight in adolescence or early adulthood AOR = 10.86 , 95 % C I 4.82 − 24.4 , p < 0.001 , history of primary infertility AOR = 33.8 , 95 % C I 3.5 − 321.5 , p = 0.002 , nulliparity AOR = 3.75 , 95 % C I 1.61 − 8.75 , p = 0.002 , and a history of benign breast disease AOR = 6.06 , 95 % C I 1.19 − 30.73 , p = 0.03 were associated with the occurrence of premenopausal breast cancer. There was no significant difference between risk factor stratification per molecular subtype. Conclusion. Several reproductive, environmental, and lifestyle risk factors have been identified to be associated with premenopausal BC. Among them, alcohol intake and obesity/overweight during adolescence/early adulthood can be modified. Interventions targeting alcohol consumption and obesity/overweight in adolescents and young adults may decrease the incidence of premenopausal breast cancer.

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Section: Discussionmentioning

confidence: 99%

“…We have learned from previous studies that registries are still scarce in Africa and few available data are generally from hospital-based logs. On the continent, accurate data are generally missing [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study

Ntirenganya

Twagirumukiza

Bucyibaruta

et al. 2021

International Journal of Breast Cancer

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“…In-service training or continuing education of Rwandan nurses and midwives in practice settings about cancer preventive measures and early identification (e.g. Clinical Breast Examination) were started in 2015 at the Butaro Cancer Center of Excellence and its catchment district [25]. The evaluation of the outcomes of this brief training showed that the knowledge about breast cancer and skills in evaluating and managing breast concerns were significantly improved [26].…”

Section: Continuous Professional Development For Nurses and Midwives mentioning

confidence: 99%

Oncology nursing education and practice: looking back, looking forward and Rwanda’s perspective

Uwayezu

Sego

Nikuze

et al. 2020

ecancer

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Background: Oncology care is a highly specialised division of nursing which requires a higher level of training and education following basic preparation. Rwanda, a developing country, initiated education of oncology nurse specialists in 2015. This paper highlights the experience of establishing the programme. Methods: Selected literature and expert oncology nurses were consulted to provide direction for the development of this paper. The websites of oncology nursing organisations and the curriculum used by the University of Rwanda for preparing oncology nurses were also reviewed. Results: In 2015, Rwanda initiated the training of oncology nurse specialists (master's level). The programme has had two successful cohorts graduating. This programme is implemented in a module system with 14 modules. The modules emphasised on screening and diagnosis of different cancers and their treatment, management of treatment related side effects, palliative care, end-of-life care and rehabilitation. A part this formal education, Rwanda, through Partners in Health and the Rwanda Biomedical Center, is also offering in-service training of nurses on cancer treatment, preventive measures and early identification such as Clinical Breast Examination and screening of cervical cancer. Conclusion. Oncology nurses can play a key role in the care of cancer patients and prevention activities when they have the appropriate education. Rwanda's experience in establishing a master's programme in oncology nursing could be of assistance to others who wish to develop a similar programme.

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“…Outside country-specific initiatives to integrate cancer centres, notable models have been developed to bring together cancer centres with a site-specific and typespecific focus-eg, breast cancer in Rwanda. 59 With the considerable reduction of childhood communicable disease mortality over the past two decades in many LMICs, an expected increase in the incidence of childhood cancers (to that of HICs in the 1960s) has occurred. 60 Many LMICs have created paediatric cancer centres to diagnose and treat children with cancer, often with the help of international twinning partners.…”

Section: Changes In Health Policymentioning

confidence: 99%

Developing institutions for cancer care in low-income and middle-income countries: from cancer units to comprehensive cancer centres

Sirohi

Chalkidou

Pramesh

et al. 2018

The Lancet Oncology

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Global cancer centres operate across different sizes, scales, and ecosystems. Understanding the essential aspects of the creation, organisation, accreditation, and activities within these settings is crucial for developing an affordable, equitable, and quality cancer care, research, and education system. Robust guidelines are scarce for cancer units, cancer centres, and comprehensive cancer centres in low-income and middle-income countries. However, some robust examples of the delivery of complex cancer care in centres in emerging economies are available. Although it is impossible to create an optimal system to fit the unique needs of all countries for the delivery of cancer care, we summarise what has been published about the development and management of cancer centres in low-income and middle-income countries so far and highlight the need for clinical and political leadership.

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A national framework for breast cancer control: A report on Rwanda’s inaugural symposium on the management of breast cancer

Cited by 5 publications

References 19 publications

Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study

Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study

Oncology nursing education and practice: looking back, looking forward and Rwanda’s perspective

Developing institutions for cancer care in low-income and middle-income countries: from cancer units to comprehensive cancer centres

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