Review of general surgery 1984–85

Clinicopathologic study of breast lumps in Abakaliki, South Eastern Nigeria

“…19 The frequency of invasive ductal cancer among cancer cases in this study (75.0%) is in consonance with figures documented in Sokoto 18 ( 76.2%), Nigeria and Yemen 21 ( 86.6%). Similar results were noted by Ellis 23 from a referral hospital in London. This perhaps highlights the fact that the differences in the clinical profile of breast cancer in Africa and western economies are not due to histologic types, but may be related to tumor biology, delay in presentation, poverty and socio-cultural practices.…”

“…4 Overall, breast cancer (43.7%) accounted for significant proportion of breast biopsies in this study, similar to a figure of 37.2% in Maiduguri, 22 Nigeria. Of note, breast cancer is commoner than benign lesion in Nnewi 7 Nigeria, Pakistan 2 and London 23 where cancer preponderance was ascribed to selective referral of cancer cases to tertiary hospitals like ours while benign lumps are generally managed in private hospitals.…”

Review of general surgery 1985

“…In last year's review (Ellis, 1985) I discussed the increasing interest in the treatment of early breast cancer by local excision of the tumour ('lumpectomy') followed by radical radiotherapy which we have now practised exclusively in my own Unit in Westminster over the past 6 years. I pointed out the ethical problems of carrying out a controlled trial comparing this conservative treatment with conventional mastectomy, which many of us have considered insuperable; how could we say to our patients that the decision on whether or not she was to lose the breast depended on the drawing of a random number?…”