How Effective is the Treatment of Locally Advanced and Metastatic Breast Cancer in Developing Centres?: A Retrospective Review

Agodirin, Olayide; Samuel, Olatoke; Ganiyu, Rahman; Moses, A. I.; Gafar, Oyeyemi; Abiola, Durojaiye; Dapo, Kolawole; Agboola, John

doi:10.4314/ejhs.v25i4.7

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…Cut-off of 100mm size was used for group separation in this study because previous studies in Nigeria showed conflicting reports based on cut-off value of 100mm 7 , 11 . 50% cut-off was elected because tumours previously reported in the study centre and Nigeria were large 5 , 7 , 10 ; thus, small changes in tumour size was often not sufficient to advance patient care. Data extracted from eligible records included information about maximum of 6 cycles of NAC.…”

Section: Methodsmentioning

confidence: 99%

“…In developing countries, primary breast cancer tumours in excess of 5cm diameter is the norm. Clinicians in Nigeria and many developing countries frequently face the challenge of making treatment decisions on large tumours sometimes ranging beyond 30cm in diameter and sometimes occupying the whole breast 6 , 8 – 10 . Despite this, relationship between size and physical characteristics of tumour and response to NAC has not be adequately studied in these centres and the role of size as a physical factor predicting response to chemotherapy has not been clarified.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between tumour size and response to neoadjuvant chemotherapy among breast cancer patients in a tertiary center in Nigeria

et al. 2014

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BackgroundTumour biology, physiologic features such as growth fraction and physical features such as size may influence response of breast cancer to neoadjuvant chemotherapy. Molecular biology is an established basis for predicting response and selecting neoadjuvant chemotherapy. Whether physical characteristics such as size should influence chemotherapy regimen is inconclusive and has not been adequately studied in developing countries.AimTo determine the relationship between breast tumour size and response to neoadjuvant chemotherapy and hence define the role of tumour size during selection of neoadjuvant chemotherapy regimen for locally advanced breast cancer.MethodRecords of women managed at the University of Ilorin Teaching Hospital, Ilorin Nigeria, with neoadjuvant chemotherapy (NAC) for locally advanced breast cancer were reviewed between January 2013 and June 2015. Data was analyzed as 2 subgroups; primary tumour ≥100mm as group 1 and primary tumour ≥100mm as group 2. Primary outcome was 50% reduction in tumour size. Comparison was by chi-square test of independence at p value 0.05.Results57 records were reviewed (group1=24, group2=33). Majority (37( 65%)) were premenopausal. Mean age was 47.9 ± 13.1 (range 28–85). NAC was either taxane or anthracycline based regimen. Median chemotherapy dose was 4 (range 2–6). Widest diameter of tumours was 30mm to 180mm (mean 96 ±3.8mm, median 100mm). Mean tumour diameter for groups 1 and 2 was 7.2 ±1.6mm and 12.2± 2.9mm respectively. 50% reduction in tumour size was 45.8% and 6.0% for groups 1 and 2 respectively (p=0.0001)ConclusionThere was relationship between breast tumour size and response to neoadjuvant chemotherapy at a cut-off of 10mm. Well-designed prospective studies are required to confirm this relationship.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between tumour size and response to neoadjuvant chemotherapy among breast cancer patients in a tertiary center in Nigeria

et al. 2014

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“…Breast cancer (BC) patients in low and middle-income countries (LMICs) and black patients in developed countries harbor symptoms for up to 8-12 months [1][2][3][4][5] before diagnosis and treatment thereby increasing the risk of poor outcome and limiting treatment efficacy [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Presentation intervals and the impact of delay on breast cancer progression in a black African population

et al. 2020

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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 detectionto-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 (> 5 cm) 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 ± 4.9 cm (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.

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“…The primary objective was to describe the contribution of each interval to the continuum. The secondary objectives were (1) to describe the association between the interval length and the socio-demographics, the disease-related experience(s), and system-related experience(s) (2) To describe the impact of long intervals on BC progression.…”

Section: Introductionmentioning

confidence: 99%

Presentation Intervals and the Impact of Delay on Breast Cancer Progression in a Black African Population

Agodirin

Olatoke

Rahman

et al. 2020

Preprint

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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.

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How Effective is the Treatment of Locally Advanced and Metastatic Breast Cancer in Developing Centres?: A Retrospective Review

Cited by 12 publications

References 17 publications

Relationship between tumour size and response to neoadjuvant chemotherapy among breast cancer patients in a tertiary center in Nigeria

Relationship between tumour size and response to neoadjuvant chemotherapy among breast cancer patients in a tertiary center in Nigeria

Presentation intervals and the impact of delay on breast cancer progression in a black African population

Presentation Intervals and the Impact of Delay on Breast Cancer Progression in a Black African Population

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