Evaluation des facteurs pronostiques dans le cancer du sein chez la femme au Sénégal : à propos de 288 cas

Abstract

INTRODUCTION: In Senegal, breast cancer is the second female cancer and poses a major public health problem. The aim of this work was to assess prognostic factors in the progression of breast cancer in women. PATIENTS AND METHODS: This is a retrospective study carried out over a period of one year from January 1, 2008 to December 31, 2008 on all the women followed for breast cancer in the oncology department at the Joliot Curie Institute. Thus, 288 breast cancer patients were collected. RESULTS: The average age of our patients was 47.32 years. The average parity was 4.9 children per woman. Twenty-two or 7% of patients had a history of cancer. Clinically, the tumor size was classified as T4 in 180 patients, ie 81%. Lymph node involvement in 188 patients (65.2%). The most frequent histological type was invasive ductal carcinoma with 90.3% of cases. A predominance of grades SBRII and SBRIII was observed (respectively 41% and 46%). Hormone receptors (RH) were positive in eight cases (24%). Overexpression of the HER2 gene was found in only four out of 30 patients. The limits of the surgery were specified in 48 patients with invaded margins in seven patients (14.5%). The presence of vascular emboli was noted in 18 patients among the 29 whose research was carried out in 179 patients, ie 62%. At the time of the initial diagnosis, 45 patients or 19.7% of patients presented at least one distant metastasis. The majority of patients were received at an advanced stage (89%, classified between stage III and IV). Only one patient was received at stage I. Overall survival for breast cancer was 72% at 3 years and 30% at 5 years. The 5-year overall survival of patients with localized disease was 85% compared to 5% for patients with advanced stage. CONCLUSION: The prognostic factors are multiple and often pejorative in our patients with a predominance of young women, locally advanced cancers and aggressive biological forms.