Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Evolutionary aspects of non-metastatic breast cancer after primary treatment in a sub-Saharan African setting: a 16-year retrospective review at the Douala general hospital, Cameroon

Authors: Bibiana Ateh Nzeangung, Martin Essomba Biwole, Benjamin Momo Kadia, Ndemazie Nkafu Bechem, Christian Akem Dimala, Albert Mouelle Sone

Published in: BMC Cancer | Issue 1/2018

Login to get access

Abstract

Background

Breast cancer has a high case fatality rate in sub-Saharan Africa, and this is chiefly because of late detection and inadequate treatment resources. Progressive renovations in diagnostic and management modalities of non-metastatic breast cancer (NMBC) have been noted in the region but there is paucity of data describing the clinical progress of patients with NMBC. This study sought to determine the rates of local relapse, distant metastasis and sequelae and the time span from initial treatment to the occurrence of these adverse events among patients with NMBC.

Methods

This was a retrospective review of medical records of patients with histologically confirmed NMBC at the department of radiation therapy and oncology of the Douala General Hospital in Cameroon from the January 1997 to December 2012 period. Clinicopathological and treatment characteristics as well as occurrences of adverse events were studied.

Results

A total of 260 cases were reviewed of which 224/260 (86.2%) had invasive ductal carcinoma. Surgery was performed on 258/260 cases (99.2%) with 187/258 (72.5%) being modified radical mastectomies. Various treatment combinations were used in up to 228/260 patients (87.5%) while surgery alone was the treatment in the remaining 32 cases (12.5%). Metastasis occurred in 142/260 cases (54.6%) of which 68/142 (26.2%) were local relapses and 74/142 (28.5%) were distant metastases. Among the cases of distant metastasis, 9.2% were bone, 8.5% lungs, 6.9% nodal, and 5.4% brain. Metastasis to multiple organs was noted in 4.7% of these cases. The median periods of occurrence of local relapse and distant metastases were 13 and 12 months respectively. Sequelae occurred in 26/260 cases (10%) and were noted after an average of 30 months. The main sequelae were lymphoedema (6.5%) and lung fibrosis (1.5%). At the end of the period under review, 118/260 patients (45.4%) were alive and disease-free with a median follow up time of 24 months.

Conclusions

Adverse events were frequent among patients who received primary treatment for NMBC. Available cancer therapeutic modalities ought to be supplemented with efficient strategies of follow-up and monitoring so as to optimize the care provided to these patients and improve on their survival.

Literature
  1. Kantelhardt EJ, Cubasch H, Hanson C. Taking on breast cancer in East Africa: global challenges in breast cancer. Curr Opin Obstet Gynecol. 2015;27:108–14.View ArticlePubMed
  2. Ginsburg OM. Breast and cervical cancer control in low and middle-income countries: human rights meet sound health policy. J Cancer Policy. 2013;1:e35–41.View Article
  3. Chokunonga E, Borok MZ, Chirenje ZM, Nyakabau AM, Parkin DM. Trends in the incidence of cancer in the black population of Harare, Zimbabwe 1991– 2010. Int J Cancer. 2013;133:721–9.View ArticlePubMed
  4. Jemal A, Bray F, Forman D. O1'Brien M, Ferlay J, center M, Parkin DM. Cancer burden in Africa and opportunities for prevention. Cancer. 2012;118(18):4372–84.View ArticlePubMed
  5. Enow-Orock G, Ndom P, Doh AS. Current cancer incidence and trends in Yaounde. Cameroon Oncol Gastroenterol Hepatol Rep. 2012;1(1):58–63.View Article
  6. Pace LE, Shulman LN. Breast cancer in sub-Saharan Africa: challenges and opportunities to reduce mortality. Oncologist. 2016;21(6):739–44.View ArticlePubMedPubMed Central
  7. Schmitz KH, Speck RM, Rye SA, DiSipio T, Hayes SC. Prevalence of breast cancer treatment sequelae over 6years of follow up. Cancer. 2012;118(8):2217–25.View ArticlePubMed
  8. Nguefack CT, Biwole ME, Massom A, Kamgaing JT, Njamen TN, Ekane GH, et al. Epidemiology and surgical management of breast cancer in the gynecological Department of Douala General Hospital. Pan Afr Med J. 2012;13:35.PubMedPubMed Central
  9. Abdulhadi TJ. Non metastatic breast cancer: clinical presentation and patterns of surgical treatment. Al Kindy Col Med J. 2009;5(1):40–6.
  10. Millar EKA, Graham PH, O’Toole SA, McNeil CM, Browne L, Morey AL, et al. Prediction of local recurrence, distant metastases and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol. 2009;27:4701–8.View ArticlePubMed
  11. Diniz RW, Guerra MR, Cintra JRD, Fayer VA, Teixeira MTB. Disease-free survival in patients with non-metastatic breast cancer. Rev Assoc Med Bras. 2016;62(5):407–13.View ArticlePubMed
  12. Budakoglu B, Altundag K, Aksoy S, Kaplan MA, Ozdemir NY, Berk V, et al. Outcome of 561 non-metastatic triple negative breast cancer patients: multicenter experience from Turkey. J BUON. 2014;19(4):872–8.PubMed
  13. Jamshed A, Shah MA, Syed AA, Murtaza G, Mehmood T, Chaudry SA, et al. Clinical outcome of primary non-metastatic breast cancer: a single institution experience. Indian J Cancer. 2015;52:119–25.View ArticlePubMed
  14. Alieldin NH, Abo-Elazm OM, Bilal D, Salem SE, Gouda E, Elmongy M, et al. Age at diagnosis in women with non-metastatic breast cancer. Is it related to prognosis? J Egypt Natl Canc Inst. 2014;26:23–30.View ArticlePubMed
  15. Mathew A, Rajan B, Panday M. Do younger women with non-metastatic and non-inflammatory breast carcinoma have poor prognosis? World J Surg Oncol. 2004;2:2.View ArticlePubMedPubMed Central
  16. Danforth JDN. Disparities in breast cancer outcomes between Caucasian and African American women: a model for describing the relationship of biological and nonbiological factors. Breast Cancer Res. 2015;15:208.View Article
  17. Popoola AO, Ibrahim NA, Omodele FO, Oludara MA, Adebowale SA, Igwilo AI. Pattern of spread of breast cancer among patients attending cancer unit of Lagos state university teaching hospital. Asian J Med Sci. 2012;4(3):89–94.
  18. Ohene-Yaboah M, Adjei E. Breast cancer in Kumasi. Ghana Ghana Med J. 2012;46(1):8–13.
  19. Ogundiran OT, Ayandipo OO, Ademola AF, Adebamowo CA. Mastectomy for management of breast cancer in Ibadan. Nigeria BMC Surg. 2013;13:59.View ArticlePubMed
  20. Essiben F, Foumane P, Mboudou ET, Dohbit JS, Mve Koh V, Ndom P. Diagnosis and treatment of breast cancer in Cameroon: A series of 65 cases. Mali Medical. 2013;28:1-5.
  21. Elumelu TN, Adenipekun AA, Abdusalam AA, Bojude AD. Pattern of breast cancer metastasis at the radiatiotherapy clinic, Ibadan. A ten year review. J Am Sci. 2011;7(7):906–12.
  22. Donkor A. Factors contributing to late presentation of breast cancer in Africa: a systematic literature review. Arch Med. 2015;8:2.
  23. Noufel SM, AL-mukhtar R, Al-Dawoodi NS, Sulaiman TI. Recurrent breast cancer following modified radical mastectomy and risk factors. J Fac Med Baghdad. 2012;54(3):198–203.
  24. Donnelly J, Mack P, Donaldson LA. Follow up of breast cancer: time for a new approach? Int J Clin Pract. 2001;55(7):431–3.PubMed
  25. Chauleur C, Vulliez L, Trombert B, Raoux D, Khaddage A, Seffert P. Facteurs de risque de récidive des cancers du sein traités par chirurgie conservatrice: a propos de 254 cas. J Gynecol Obstet Biol Reprod. 2008;37:170–8.View Article
  26. Ersumo T. Breast cancer in an ethiopian population, Addis Ababa. East and Central Afr J Surg. 2006;11(1):81–6.
  27. Raina V, Bhutani M, Bedi R, Sharma A, Deo Suryanarayana VS, Shukla NK, et al. Clinical features and prognostic factors of early breast cancer at a major cancer center in North India. Indian J Cancer. 2005;42(1):36–41.
  28. Elder EE, Kennedy CW, Gluch L, Carmalt HL, Janu N, Joseph MG et al. patterns of breast cancer relapse. Eur J Surg Oncol 2006; 32(9): 922-927.
  29. Mabula JB, Mabula MD, Chalya PL, Giiti G, Chandika AB, Rambau P, et al. Stage at diagnosis, clinicopathological and treatment patterns of breast cancer at Bugando medical center in north western Tanzania. Tanzan J Health Res. 2012;14(4):1–14.
  30. Kene TS, Odigie VI, Yusufu LMD, Shehu SM, Kase JT. Pattern of presentation and survival of breast cancer in a teaching Hospital in North Western Nigeria. Oman Med J. 2010;25:104–7.View ArticlePubMedPubMed Central
  31. Manders K, Van de Poll-Franse LV, Creemers GJ, Vreugdenhil G, Van der Sangen MJ, Nieuwenhuijzen GA, et al. Clinical management of women with metastatic breast cancer: a descriptive study according to age group. BMC Cancer. 2006;6:179.View ArticlePubMedPubMed Central
  32. Berman AT, Thukral AD, Wei-Ting H, Solin LJ, Vapiwala N. Incidence and patterns of distant metastasis for patients with early stage breast cancer after breast conservation treatment. Clin Breast Cancer. 2013;13(2):88–94.View ArticlePubMed
  33. Shahpar H, Atieh A, Maryam A, Fatemeh HS, Massoome N, Mandana E et al. Risk factors of lymph edema in breast cancer patients. Int J Breast Cancer 2013; 2013: 641818 doi.org/https://​doi.​org/​10.​1155/​2013/​641818
  34. Anna P. An analysis of long term complications in breast cancer patients after conservative therapy. Rep Pract Oncol Radiother. 2006;11(2):81–9.View Article
  35. Kornblith AB. Herndon 11 JE, Weiss RB, Zhang C, Zuckerman EL, Rosenberg S et al.Long-term adjustment of survivors of early-stage breast carcinoma, 20years after adjuvant chemotherapy. Cancer. 2003;98(4):679–89.View ArticlePubMed
Metadata
Title
Evolutionary aspects of non-metastatic breast cancer after primary treatment in a sub-Saharan African setting: a 16-year retrospective review at the Douala general hospital, Cameroon
Authors
Bibiana Ateh Nzeangung
Martin Essomba Biwole
Benjamin Momo Kadia
Ndemazie Nkafu Bechem
Christian Akem Dimala
Albert Mouelle Sone
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3984-z

Other articles of this Issue 1/2018

BMC Cancer 1/2018 Go to the issue

Research article

Genetic and immunological biomarkers predict metastatic disease recurrence in stage III colon cancer

Research article

Diethylnitrosamine induces lung adenocarcinoma in FVB/N mouse

Study protocol

HIPECT4: multicentre, randomized clinical trial to evaluate safety and efficacy of Hyperthermic intra-peritoneal chemotherapy (HIPEC) with Mitomycin C used during surgery for treatment of locally advanced colorectal carcinoma

Research article

A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database

Research article

Local response and pathologic fractures following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy for spinal metastases - a randomized controlled trial

Study protocol

Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS): prospective cohort study protocol
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits