Stage at presentation of breast cancer in Luanda, Angola - a retrospective study

Lopes, Lygia Vieira; Miguel, Fernando; Freitas, Helga; Tavares, Ana; Pangui, Salvador Manuel; Castro, Clara; Lacerda, GonÃ§alo Forjaz; Longatto‐Filho, Adhemar; Weiderpass, Elisabete; Santos, Lúcio Lara

doi:10.1186/s12913-015-1092-9

Cited by 22 publications

(20 citation statements)

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“…Although there is clearly variability among countries in SSA, one factor responsible for the late stage at presentation is secondary to a limited health care infrastructure that precludes access to timely clinical care and the resulting lack of medical surveillance. 9 - 12 Similarly, in the United States, in a study linking cancer registry data with registry data from HIV and AIDS and solid-organ transplant populations, both of which are immunosuppressed groups, it was observed that HIV-infected patients were more likely to present at an advanced stage of lung, breast, and prostate cancer than were immunocompetent patients. In contrast, solid-organ transplant patients were more likely to present with early-stage cancer than were immunocompetent patients, suggesting a potential role of medical surveillance and increased vigilance among transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute

Menon

Coghill

Mutyaba

et al. 2018

JGO

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PurposeThe HIV epidemic has contributed to the increasing incidence of cancer in sub-Saharan Africa, where most patients with cancer present at an advanced stage. However, improved access to HIV care and treatment centers in sub-Saharan Africa may facilitate earlier diagnosis of cancer among patients who are HIV positive. To test this hypothesis, we characterized the stage of cancer and evaluated the factors associated with advanced stage at presentation among patients in Uganda.MethodsWe conducted a retrospective analysis of adult patients with any of four specific cancers who presented for care in Kampala, Uganda, between 2003 and 2010. Demographic, clinical, and laboratory data were abstracted from the medical record, together with the outcome measure of advanced stage of disease (clinical stage III or IV). We identified measures for inclusion in a multivariate logistic regression model.ResultsWe analyzed 731 patients with both AIDS-defining cancers (cervical [43.1%], and non-Hodgkin lymphoma [18.3%]), and non–AIDS-defining cancers (breast [30.0%] and Hodgkin lymphoma [8.6%]). Nearly 80% of all patients presented at an advanced stage and 37% had HIV infection. More than 90% of patients were symptomatic and the median duration of symptoms before presentation was 5 months. In the multivariate model, HIV-positive patients were less likely to present at an advanced stage as were patients with higher hemoglobin and fewer symptoms.ConclusionPatients with limited access to primary care may present with advanced cancer because of a delay in diagnosis. However, patients with HIV now have better access to clinical care. Use of this growing infrastructure to increase cancer screening and referral is promising and deserves continued support, because the prognosis of HIV-positive patients with advanced cancer is characterized by poor survival globally.

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Section: Introductionmentioning

confidence: 99%

Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute

Menon

Coghill

Mutyaba

et al. 2018

JGO

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“…In Angola, a country with 3600 doctors, 33,000 nurses, 510 pharmacists and close to 3000 health facilities serving a total population of 25.7 million (65% less than 24-year old and a life expectancy at birth for women of 63 years according to the National Statistics Institute), a similar trend is observed [ 6 ]. In Angola, most BC cases are also diagnosed at advanced stages, at a young age and present low survival rates [ 7 , 8 ]. In these stages, management of BC requires an extensive and urgent approach combining actions such as surgery, timely access to cost-effective chemotherapy (cytotoxic, hormone, and target therapies) and/or radiation therapy [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Breast cancer in Angola, molecular subtypes: a first glance

Miguel¹,

Lopes²,

Ferreira³

et al. 2017

ecancer

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PurposeThe aim of this study was to investigate the breast cancer (BC) molecular subtypes according to its surrogate immunohistochemistry (IHC) markers. We conducted a preliminary study, to correlate the clinical pathological profiles and molecular subtypes of breast cancer in Luanda, Angola.MethodsFrom January 2011 to 30 December 2014, 140 consecutive cases of microscopically confirmed invasive breast carcinoma were classified regarding histology and IHC (ER, PR, HER2, and Ki-67). Surrogate molecular subtypes were classified according to ESMO recommendations.ResultsAll patients were female; the median age was 47 years (24–84 years). Invasive carcinoma NST was the most common type (91.4%) and grade 2 was prevalent (70.7%). Most tumours were locally advanced (stage III – 65% and stage IV – 3.6%). In 140 studied cases, 74 (52.8%) malignancies were hormone receptor positive; 25.7% were luminal A like, 19.3% luminal B and HER2 negative like, 7.9% luminal B and HER2-positive like, 15.7% HER2 positive, and 31.4% were triple negative.ConclusionWomen’s BC in Luanda-Angola is diagnosed at a young age and at an advanced stage. The two predominant molecular subtypes are HR positive and triple negative. The percentage of HER2-positive BC cases was high. Determining the molecular subtype using surrogate IHC markers has important treatment and prognostic implications for Angolan women with BC. There is an urgent need to study a prospective BC series in order to confirm the present results.

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“…We employ several validated measures of disease severity (11), while acknowledging the need for further development of ME/CFS-specific outcome measures. For example, patient-based assessments of disease impact or severity, such as the SF-36v2 TM , have been used in a variety of clinical settings and are monitored in clinical research to add to our understanding of disease severity, treatment outcomes, and therapeutic response (12).…”

Section: Features Of the Ukmeb Protocolmentioning

confidence: 99%

The UK ME/CFS Biobank: A Disease-Specific Biobank for Advancing Clinical Research Into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2018

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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling disease characterized by unexplained incapacitating fatigue, accompanied by variable multi-systemic symptoms. ME/CFS causes a significant personal and public health burden, and urgently requires the coordination of research efforts to investigate its etiology and pathophysiology and to develop and validate sensitive and specific biomarkers to confirm diagnosis. This narrative paper describes how people with ME/CFS, together with a multidisciplinary team of researchers, have established the UK ME/CFS Biobank (UKMEB), a unique research infrastructure specifically designed to expedite biomedical research into ME/CFS. We describe the journey that led to its conceptualization and operation, and how the resource has served as a model disease-specific biobank, aggregating human biospecimens alongside comprehensive health information on participants. The UKMEB currently has data and samples from 600 donors including people with ME/CFS and a comparison group with multiple sclerosis and healthy controls. A longitudinal sub-cohort has been established of participants having follow-up assessments at multiple time-points. As an open resource for quality and ethical research into ME/CFS, biological samples and data have not only been analyzed within our research team but have also been shared with researchers across Europe, America and the Middle East. We continue to encourage researchers from academic and commercial sectors to access the UKMEB. Major steps have been taken and challenges remain; these include sustainability and expansion, and harmonization of processes to facilitate integration with other bioresources and databanks internationally.

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Stage at presentation of breast cancer in Luanda, Angola - a retrospective study

Cited by 22 publications

References 18 publications

Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute

Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute

Breast cancer in Angola, molecular subtypes: a first glance

The UK ME/CFS Biobank: A Disease-Specific Biobank for Advancing Clinical Research Into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

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