Profile of patients seen at Pietersburg and Mankweng breast cancer clinics in Limpopo

Abstract

Breast cancer is the most prevalent cancer and leading cause of death among women worldwide. [1] The average lifetime risk of breast cancer for a wom an in the USA has been estimated at 12.3% with about 41 400 deaths reported in 2018. [1] The global incidence increased from 1.7 million in 2005 to 2.4 million cases in 2015 [2] and in Africa is predicted to double by 2050. [3] Incidence rates are lower in low-and middle-income countries (LMICs) than in high-income countries; however, the rates are increasing very rapidly in LMICs owing to adoption of a western lifestyle, including such habits as shorter breastfeeding time, use of postmenopausal hormonal therapy, late age at first term pregnancy or lower parity. Another risk factor of breast cancer is physical inactivity, leading to obesity. [4] The incidence in sub-Saharan Africa was estimated to be 22.4 per 100 000 cases in 2018. [5] Breast cancer mortality rates in LMICs remain high as a result of late presentations and inadequate access to good healthcare. [6] Breast cancer, along with cervical cancer, has been identified as a priority for the national healthcare services in South Africa (SA). [7] The SA National Cancer Registry reported breast cancer in 2014 as a leading cause of cancer deaths among women. [8] A 5-year mortality rate of 47% was recorded for SA women. [9] Breast cancer as a social problem has become an urgent challenge in LMICs. It is increasing dramatically, with 19.7 million cases projected to occur in the next decades. [10,11] This present study is the first to report the demographic profile, stage at presentation, and the characteristics of breast cancer patients in Limpopo Province, SA. Before March 2015, breast cancer patients were managed by surgeons in the general surgery department, together with patients admitted for other surgical conditions. Breast cancer patients would wait 3 -6 months for operations. In March 2015, a multidisciplinary clinic for the care of breast cancer patients was established at Mankweng Hospital. This hospital is a tertiary teaching institution of the University of Limpopo located 30 km east of Polokwane, the provincial capital.The clinic at Mankweng is the only such facility in Limpopo serving the population of 5.98 million people. [12] The clinic operates once a week, staffed with adequate personnel, but does not have its own oncology and radiation facilities; for these services, the clinic is dependent on the radiation department at Pietersburg Hospital 30 km away.The main objective of this study was to record the demographic features of attending patients, stage at presentation and histological patterns of malignancy identified in breast cancer patients treated at Mankweng. We anticipate that the information obtained from this study will guide the authorities responsible for provincial policy on breast cancer prevention, treatment and resource allocation programmes. MethodsWe conducted a retrospective, descriptive, cross-sectional record review of patients managed at Mankweng breast cancer clinic during the...

Spindle cell carcinoma of the breast: a case study report from Mankweng hospital & literature review

“…Our patient was a 58-year-old female who presented at an advanced stage despite a growing rapidly breast mass. A previously published study by our institution by Bhuiyan et al [8] and other literature showed that breast cancer patients typically present late in this province. This patient is not different from others in terms of the timing of presentation to the hospital.…”

“…This patient is not different from others in terms of the timing of presentation to the hospital. There are several factors contributing to the late presentation of breast cancer, which include lack of knowledge about breast cancer, symptoms of breast cancer, low levels of education, low socioeconomic status, traditional healer and spiritual beliefs and fear of hospitalisation [8,9].…”

Profile and Features of Breast Cancer in HIV Positive and Negative Patients at Mankweng Academic Hospital, Limpopo Province, South Africa

“…11 A similar trend was found among the women in Limpopo, South Africa. 12 No significant difference in the histological subtype of breast cancer was found between HIV-positive & HIV-negative patients. In our study, most (33) of HIV-positive patients presented with breast cancer in stage III (76.7%) and 8 patients (18.6%) with stage II.…”

“…11 A study done in Limpopo, in SA, showed that 38% of breast cancer patients were younger than 50 years. 12 Tygerberg Academic Hospital in SA reported a median age at presentation of 56 years for patients without HIV compared with 42 years for patients with HIV (P<001). 13 Edge et al found that patients with breast cancer in SSA usually appear to be at a younger age, irrespective of HIV infection.…”

Surgical challenges in Limpopo

“…[2,3] This is followed by a two-year review of patients seen at the Pietersburg and Mankweng hospitals breast cancer clinic and a review of the profile of molecular subtyping of breast cancer and clinicopathological features. [4,5] Finally, the third part consists of a number of interesting surgical case reports, to provide an indication of the length and depth of surgical challenges in Limpopo Province. The first three case reports pertain to special cases of breast cancer.…”