International Journal of Research and Scientific Innovation (IJRSI) | Volume IX, Issue VI, June 2022 | ISSN 2321–2705
Breast Cancer-Why We Present Late
Dr. Ma. Adeyanju.
Consultant General Surgeon.
Abstract: Breast cancer incidence is relatively lower in Africa. However, despite its relatively lower incidence, the mortality rate is quite high compared to the west. One of the reasons for the high mortality is late presentation.
This prospective study sought to find out the reasons for the late presentation.
Materials And Methods
Consecutive patients diagnosed with Breast Cancer at any stage were recruited into the study. A well-structured questionnaire was prepared, oral consent obtained after carefully explaining the purpose of the study. History was taken and physical examination done. The patients were then classified into stages and those in stages III and IV were included in this study. The questionnaires were filled by directly questioning the patients.
Data was analyzed by IBM SSPS statistics 24.
Result
There were 131/191 (68.6%) respondents who presented late in stages III & IV, all females, with an age range of 25-88 years and a mean of 48.69 (SD 11.35). The highest incidence is in the age range 40-49 with 25.2% (33/131) while the least incidence is found in the age range 80-89 with 4.6% (6/131) only. Of 131 respondents, 75 (57.3%) sought unorthodox help initially when they noticed a problem in their breasts, 4(34.4%) sought some form of orthodox help including visiting health workers at home, going to chemists/ pharmacies while only 11 (8.3%) presented first to our center. Out of 131 respondents, 14.8% (18/131) cited lack of funds, 30.3% (37/131) church/pastors/priests/prayers, 11.5% (14/131) fear of mastectomy, 30.3% (37/131) lack of awareness/knowledge, 39.3% (48/131/) herbal remedy. Other reasons include self-medication, trust in God, hope, etc.
Keywords: Breast Cancer, Late Presentation, Mastectomy, Neoadjuvant Chemotherapy
I. INTRODUCTION
Breast cancer incidence is relatively lower in Africa, with the women said to have one of the lowest incidence rates in the world1 but this has been projected to gradually increase with an estimated 119918 new cases by 20231. However, despite its relatively lower incidence, it has high mortality rates 1,2 compared to the west and other high-incidence countries due to poor survival. For example, comparing the incidence and mortality rate of Breast cancer in different parts of the world, it was found that while the incidence rates are 18.2 and 103.7 cases per 100,000 population in West Africa and the developed part of the world, the mortality rates are 12.6 and 30.9 per 100,000 respectively3. Similar studies in South Africa showed 48%4 of new patients required neo-adjuvant or palliative treatment because of late presentation. This is the situation in Enugu Nigeria where Ezeome found that 17.5% of patients reported first to alternative practioners5.