An update on the management of breast cancer in Africa

Abstract

BackgroundThere is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities.MethodsA search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms “breast cancer in Africa and developing countries”. One hundred ninety were deemed appropriate.ResultsBreast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities.ConclusionThis review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.

Evaluation of side effects and compliance to chemotherapy in breast cancer patients at a Nigerian tertiary hospital

“…This study showed that breast cancer occurs primarily in the young and middle-aged groups in this environment. This is similar to the findings of other studies in Nigeria which showed that breast cancer occurs at a younger age compared to Caucasians [4,[24][25][26].…”

Evaluation of side effects and compliance to chemotherapy in breast cancer patients at a Nigerian tertiary hospital

“…This study showed that breast cancer occurs primarily in the young and middle-aged groups in this environment. This is similar to the findings of other studies in Nigeria which showed that breast cancer occurs at a younger age compared to Caucasians [4,[24][25][26].…”

Factors associated with completeness in documentation of diagnostic work-up and treatment in patients with breast cancer in Sudan

“…Additionally, 17% of patients who did not have documentation of receptor testing received hormone therapy, suggesting either a lack of documentation of pathology results or inappropriate treatment administration. These findings were consistent with prior studies showing that deficiencies in diagnostic work-up have impelled clinicians in Sudan to blindly administer therapy irrespective of a patient’s receptor status and staging, leading to a decrease in the quality of cancer care [ 1 , 3 – 5 , 23 ]. Studies in other SSA countries have also demonstrated similar findings.…”

Characterizing factors influencing adherence to surgery and chemotherapy amongst women suffering from breast cancer in Mbingo Baptist Hospital Cameroon

“…These differences in rates of adherence could be due to differences in the approach of care and public awareness on BC as seen in Table 2 . It is similar to the results of a study carried out in Nigeria where 47.9% of patients refused the surgery and 38.6% were adherent to chemotherapy [ 5 ].…”

Evaluation of side effects and compliance to chemotherapy in breast cancer patients at a Nigerian tertiary hospital

“…This study showed that breast cancer occurs primarily in the young and middle-aged groups in this environment. This is similar to the findings of other studies in Nigeria which showed that breast cancer occurs at a younger age compared to Caucasians [4,[24][25][26].…”

Factors associated with completeness in documentation of diagnostic work-up and treatment in patients with breast cancer in Sudan

“…Additionally, 17% of patients who did not have documentation of receptor testing received hormone therapy, suggesting either a lack of documentation of pathology results or inappropriate treatment administration. These findings were consistent with prior studies showing that deficiencies in diagnostic work-up have impelled clinicians in Sudan to blindly administer therapy irrespective of a patient’s receptor status and staging, leading to a decrease in the quality of cancer care [ 1 , 3 – 5 , 23 ]. Studies in other SSA countries have also demonstrated similar findings.…”

Characterizing factors influencing adherence to surgery and chemotherapy amongst women suffering from breast cancer in Mbingo Baptist Hospital Cameroon

“…These differences in rates of adherence could be due to differences in the approach of care and public awareness on BC as seen in Table 2 . It is similar to the results of a study carried out in Nigeria where 47.9% of patients refused the surgery and 38.6% were adherent to chemotherapy [ 5 ].…”

Evaluation of side effects and compliance to chemotherapy in breast cancer patients at a Nigerian tertiary hospital

“…This study showed that breast cancer occurs primarily in the young and middle-aged groups in this environment. This is similar to the findings of other studies in Nigeria which showed that breast cancer occurs at a younger age compared to Caucasians [4,[24][25][26].…”

Factors associated with completeness in documentation of diagnostic work-up and treatment in patients with breast cancer in Sudan

“…Additionally, 17% of patients who did not have documentation of receptor testing received hormone therapy, suggesting either a lack of documentation of pathology results or inappropriate treatment administration. These findings were consistent with prior studies showing that deficiencies in diagnostic work-up have impelled clinicians in Sudan to blindly administer therapy irrespective of a patient’s receptor status and staging, leading to a decrease in the quality of cancer care [ 1 , 3 – 5 , 23 ]. Studies in other SSA countries have also demonstrated similar findings.…”

Characterizing factors influencing adherence to surgery and chemotherapy amongst women suffering from breast cancer in Mbingo Baptist Hospital Cameroon

“…These differences in rates of adherence could be due to differences in the approach of care and public awareness on BC as seen in Table 2 . It is similar to the results of a study carried out in Nigeria where 47.9% of patients refused the surgery and 38.6% were adherent to chemotherapy [ 5 ].…”