Breast disease in Timor‐Leste

Abstract

Background: Surgically treatable conditions are well documented in high-income countries. There is a gap in epidemiological understanding of breast pathology in many developing countries, Timor-Leste among them. This study was conducted to determine the burden of breast disease and to inform public health measures to address early detection, diagnosis and management. Methods: A retrospective quantitative case-control study was conducted at Guido Valadares National Hospital in Dili. Patients were included if they attended surgical outpatients or had a pathology specimen recorded between 1 September 2016 and 1 September 2017. Results: There were 444 female patients with a clinical diagnosis of breast disease over the 12-month period. The average age was 33.7 years. There were 188 (42.3% of total sample) cases of fibroadenoma and 122 (27.4% of total sample) diagnoses consistent with nonspecific lumps. Of the 116 female patients presenting to Guido Valadares National Hospital who had a biopsy, 62.6% were malignant or hyperplastic in nature, and 86% of those with a malignant biopsy had clinically locally advanced disease. Conclusion: Breast conditions including cancer in Timor-Leste are relatively common and occur in young women in the prime of their lives (37 years of age). Developing a national cancer registry and funding directed towards improving early presentation and good clinical care of breast cancer patients will be critical for reducing early morbidity and mortality and improving other patient outcomes including income loss, gender health inequality and the intergenerational effects of early parental death.

Profile of Fibroadenoma Mammae Patients at MRCCC Siloam Semanggi Hospital 2019-2020

“…This disease is often found in adolescent girls, and its incidence decreases in adulthood [2]. Age of the 2nd and 3rd decade is the most common occurrence of FAM cases [2,19]. This was proven in a study conducted by Vijayakhumar et al (2013) in India, where this study found 139 out of 210 total cases of FAM, mostly occurring at the age of 16-30 years.…”

Fibroadenoma Mammae: Prevensi Berdasarkan Karakteristik dan Faktor Risiko

“…Sebanyak 188 orang (42,3% dari total sampel) memiliki kasus fibroadenoma. 6 Lokasi fibroadenoma paling banyak adalah unilateral (86%) dan sisanya adalah bilateral Ukuran yang dilaporkan paling banyak adalah Fibroadenoma besar, yang memiliki ukuran antara 1-3cm (58%). Fibroadenoma raksasa (giant fibroadenoma) biasanya ditemui selama kehamilan atau menyusui.…”

“…7 Perempuan yang menderita fibroadenoma mammae dapat mengalami gangguan psikologis yang cukup besar, beban finansial, kehilangan pendapatan, dan komplikasi kesehatan lebih lanjut. 6,8 Etiologi dan patogenesis FAM masih belum jelas disebabkan banyak predisposisi yang komplek atau multifaktorial, tetapi penjelasan umum yang digunakan adalah kadar hormon, obesitas dan riwayat keluarga. Fibroadenoma mammae memungkinkan menjadi faktor risiko untuk kanker payudara yang invasif.…”

Global Health in the ANZ Journal of Surgery

“…Fordyce et al have documented the burden of breast disease presenting to the National Hospital in Dili, Timor Leste, reporting an alarming rate of malignancy in young women, and the need for a national registry to inform policy makers. 14 As the focus for development assistance shifts from service delivery to capacity building, educational activities are an increasing component of programmes in the region. Nataraja et al detail the results of 4 years of simulation education at Yangon Children's Hospital, Myanmar, utilizing affordable and reproducible models that could be adapted to almost any setting.…”

“…Fordyce et al . have documented the burden of breast disease presenting to the National Hospital in Dili, Timor Leste, reporting an alarming rate of malignancy in young women, and the need for a national registry to inform policy makers 14 …”