Pathological features of Breast Cancer seen in Northwestern Tanzania: a nine years retrospective study

Abstract

BackgroundBreast cancer is more common in Western Countries compared to African populations. However in African population, it appears that the disease tends to be more aggressive and occurring at a relatively young age at the time of presentation. The aim of this study was to describe the trend of Breast Cancer in Northwestern Tanzania.MethodsThis was a retrospective study which involved all cases of breast cancer diagnosed histologically at Bugando Medical Center from 2002 to 2010. Histological results and slides were retrieved from the records in the Pathology department, clinical information and demographic data for patients were retrieved from surgical wards and department of medical records. Histology slides were re-evaluated for the histological type, grade (By modified Bloom-Richardson score), and presence of necrosis and skin involvement. Data was entered and analyzed by SPSS computer software version 15.FindingsThere were 328 patients histologically confirmed to have breast cancer, the mean age at diagnosis was 48.7 years (+/- 13.1). About half of the patients (52.4%) were below 46 years of age, and this group of patients had significantly higher tendency for lymph node metastasis (p = 0.012). The tumor size ranged from 1 cm to 18 cm in diameter with average (mean) of 5.5 cm (+/- 2.5), and median size of 6 cm. Size of the tumor (above 6 cm in diameter) and presence of necrosis within the tumor was significantly associated with high rate of lymph node metastasis (p = 0.000). Of all patients, 64% were at clinical stage III (specifically IIIB) and 70.4% had lymph node metastasis at the time of diagnosis. Only 4.3% of the patients were in clinical stage I at the time of diagnosis. Majority of the patients had invasive ductal carcinoma (91.5%) followed by mucinous carcinoma (5.2%), Invasive lobular carcinoma (3%) and in situ ductal carcinoma (0.3%). In all patients, 185 (56.4%) had tumor with histological grade 3.ConclusionBreast cancer in this region show a trend towards relative young age at diagnosis with advanced stage at diagnosis and high rate of lymph node metastasis. Poor Referral system, lack of screening programs and natural aggressive biological behavior of tumor may contribute to advanced disease at the time of diagnosis.

Breast cancer survival in Ethiopia: A cohort study of 1,070 women

“…A previous study conducted from 1995 through 1999 on 125 consecutive BC cases from AA University Hospital also revealed a median age of only 40 years . Reports show a median age of 46 years in Mali ( n = 118), 46 years in Tanzania ( n = 328), 49 years in Ghana ( n = 330) and 48 years in Nigeria ( n = 192) . The differences in MFS in our age groups point to a possibly favorable prognosis in women between 50 and 59 years of age in terms of MFS.…”

Triple negative breast cancer in a poor resource setting in North-Western Tanzania: a preliminary study of 52 patients

“…The demographic and clinical pathological features seen in this study were the same as described in two previous studies, whereas breast cancer was commonly seen in pre-menopausal women at an advanced stage with a high rate of lymph node metastasis and a large tumour size [19,20]. This study shows a tendency of a low expression of ER, PR and HER-2 in the selected patients; the same trend was observed in Dar-es-Salaam, although HER-2 was not tested [8], and in the neighbouring country of Kenya [9].…”

Histological Features and Tissue Microarray Taxonomy of Nigerian Breast Cancer Reveal Predominance of the High-Grade Triple-Negative Phenotype

“…A small study on Tanzanian patients also documented large tumour sizes at presentation (mean 5.5 cm) [25]. There are no breast cancer screening programmes in African countries, and therefore the large tumour sizes reported in studies including the mean size in this study, i.e.…”

“…A study of 328 Tanzanian patients reported a mean age at onset of 47.8 years with only 17.4% of the patients being >60 years old [25]. Early onset of breast cancer has been shown in African-Americans and, only recently, also in black women in Great Britain [26].…”