Cancer du sein dans deux centres hospitaliers de Bamako (Mali): aspects diagnostiques et thérapeutiques

Togo, Alexandr V.; Traoré, A.; Traoré, Cheick Bougadari; Dembele, Benoit; Kanté, L; Diakité, I.; Maiga, Aminata; Traoré, S; Coulibaly, A. C.; Diallo, G.

doi:10.1007/s12558-010-0060-x

Cited by 21 publications

(25 citation statements)

References 7 publications

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“…Conclusion: Multilevel interventions are needed to ensure access, availability, and affordability of a minimum standard of care for breast cancer patients in sub-Saharan Africa. [13,14]. To understand major barriers to early diagnosis and treatment, we used the model of pathway to treatment [15] recommended by the Aarhus statement [16] which is intended to improve the design and reporting of studies on delayed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako, Mali

et al. 2018

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Background: Breast cancer, the most common cancer among women worldwide, has a high mortality rate in low-income countries. In sub-Saharan Africa, most breast cancer patients are diagnosed with advanced disease. Some studies have quantified the time delay to diagnosis in sub-Saharan Africa, but very few have used qualitative methods to understand barriers leading to delay. This study analyses barriers throughout a breast cancer patient's pathway from symptom recognition to treatment in Mali. Method: Three focus group discussions were conducted. The model of pathways to treatment was used to structure the results into 4 time intervals: appraisal, help-seeking, diagnosis, and treatment, with a focus on barriers during each interval. Results: The main barriers during the appraisal interval were a low level of breast cancer knowledge among women, their families, and medical professionals, and during the help-seeking interval, mistrust in the community health care centers and economic hardship. Barriers during the diagnosis interval were low quality of health care services and lack of social support, and during the pretreatment interval high costs and lack of specialized services. Conclusion: Multilevel interventions are needed to ensure access, availability, and affordability of a minimum standard of care for breast cancer patients in sub-Saharan Africa.

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Section: Introductionmentioning

confidence: 99%

Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako, Mali

et al. 2018

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“…Il représente 23% des cancers de la femme et 10,9% de tous les cancers humains au monde [ 1 ]. En Afrique, Togo a évoqué une variabilité régionale: 16% au Sénégal, 10% en République Sud-Africaine et 4% au Kenya [ 2 ]. Au Cameroun, en 1992, le cancer du sein occupait le second rang dans l’étude de Mbakop et al après celui du col, de la peau et du foie [ 3 ].…”

Section: Introductionunclassified

Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas

Engbang¹,

Henri²,

Koh³

et al. 2015

Pan Afr Med J

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Décrire les caractéristiques épidémiologiques et histo-pathologiques des tumeurs malignes du sein au Cameroun. Il s'agissait d'une étude rétrospective descriptive portant sur les tumeurs malignes du sein, colligées, dans les registres des différents laboratoires d'Anatomie Pathologique publiques et privés repartis dans cinq régions (centre, littoral, Ouest, Nord-ouest, Sud-ouest), pendant une période de 10 ans (2004-2013). Les paramètres étudiés étaient la fréquence, l’âge, le sexe, la localisation, le type et le grade histologique, et les récepteurs hormonaux. Un total de 3044 cas de cancers du sein a été recensé, soit une fréquence annuelle de 304,4 cas en moyenne. Le sexe féminin était le plus représenté avec 2971 cas (97,60%) et les hommes avec 73 cas (2,40%), soit un sexe ratio (H/F) de 0,02. L’âge moyen des patients était de 46±15,87 ans, avec des extrêmes de 13 et 95 ans. Selon la localisation, le sein gauche était atteint dans 1244 cas (52%) et le sein droit dans 1115 cas (47%). Au plan histologique, on retrouvait essentiellement des carcinomes avec 96,50% des cas, des sarcomes 1,39%, des lymphomes 1,07% et la maladie de Paget du mamelon, 1,03%. Les tumeurs épithéliales étaient infiltrantes dans 2049 cas (84,46%), avec une prédominance du carcinome canalaire infiltrant (1870 cas) et non infiltrantes dans 377 cas (15,54%). Le grade histo-pronostic de SBR avait révélé une prédominance du grade II dans 66% des cas. Les cancers du sein restent une pathologie fréquente au Cameroun et atteignent principalement la population féminine en âge de procréer. Ils sont caractérisés par la prédominance du carcinome canalaire infiltrant.

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“…Compared to developed countries, few studies have been conducted on the patient and biological characteristics of breast cancer in Sub-Saharan Africa and no data are currently available in Mali, a country with a population of 14.5 million [7], apart from a previously published retrospective study [8]. The few published epidemiologic studies have suggested that breast cancer exhibits specific features in this region of the world compared to the USA and Europe [9,10,11,12], as breast cancer in African women is reported to usually occur at a younger age and to present more aggressive features, such as high-grade tumors, estrogen receptor (ER)-negative and/or triple-negative phenotypes [ER–/progesterone receptor (PR)–/human epidermal growth factor receptor 2 (HER2)–] [13,14,15,16].…”

Section: Introductionmentioning

confidence: 99%

High Incidence of Triple-Negative Tumors in Sub-Saharan Africa: A Prospective Study of Breast Cancer Characteristics and Risk Factors in Malian Women Seen in a Bamako University Hospital

Antoine

Dembélé

et al. 2012

Oncology

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Objective: Few studies have been conducted on breast cancer in Sub-Saharan Africa and their results have been suspected to be impaired by artefacts. This prospective study was designed to determine tumor and patient characteristics in Mali with control of each methodological step. These data are necessary to define breast cancer treatment guidelines in this country. Methods: Clinical and tumor characteristics and known risk factors were obtained in a consecutive series of 114 patients. Each technical step for the determination of tumor characteristics [histology, TNM, grade, estrogen (ER) and progesterone receptors (PR), HER2, and Ki67] was controlled. Results: Patients had a mean age of 46 years. Most tumors were invasive ductal carcinomas (94%), T3-T4 (90%) with positive nodes (91%), grade III (78%), and ER (61%) and PR (72%) negative. HER2 was overexpressed in 18% of cases. The triple-negative subgroup represented 46%, displaying a particularly aggressive pattern (90% grade III; 88% Ki67 >20%). Conclusion: This study demonstrates the high incidence of aggressive triple-negative tumors in Mali. Apart from a higher prevalence of premenopausal women, no significant difference in risk factors was observed between triple-negative tumors and other tumors. The hormonal therapy systematically prescribed therefore needs to be revised in light of this study.

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Cancer du sein dans deux centres hospitaliers de Bamako (Mali): aspects diagnostiques et thérapeutiques

Cited by 21 publications

References 7 publications

Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako, Mali

Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako, Mali

Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas

High Incidence of Triple-Negative Tumors in Sub-Saharan Africa: A Prospective Study of Breast Cancer Characteristics and Risk Factors in Malian Women Seen in a Bamako University Hospital

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