Final report of Breast Cancer Care Registry at the Kenyatta National Hospital, Nairobi.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12552-e12552
Author(s):  
Nicholas Anthony Othieno-Abinya ◽  
Alice Musibi ◽  
Catherine Nyongesa ◽  
Benjamin Njihia ◽  
Andrew Gachii ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Ductal Carcinoma ◽  
Clinical Care ◽  
Significant Proportion ◽  
Relative Survival ◽  
Final Report ◽  
Early Disease ◽  
National Hospital ◽  
Kenyatta National Hospital

e12552 Background: Breast cancer is the commonest cancer among women in Kenya. We wanted to examine breast cancer seen at the Kenyatta National Hospital in relation to local factors that influence prognosis and quality of life, local variations in treatment and outcomes; describe the clinical care patterns, monitor the safety of the therapies provided to patients in a routine clinic setting. Methods: A prospective study of patients with breast cancer between 11.08.2011 and 11.09.2014 inclusive. Data included demographic details, diagnostic and staging procedures, stage, treatment and outcome. Estimates of relative survival used period approach. hi-square tests and analysis of variance (ANOVA) were utilised to make comparisons. Cross sectional data are presented in proportions, means and medians. Results: Four hundred patients were included, age range 20 to 83, median 49 years. Out 312, 65 (20.8%) were obese. Eight of 397 (2%) were smokers and 22(5.5%) took alcohol. Early disease was diagnosed in 269 out of 354 (76%) and metastatic disease in 85(24%). Breast lump presented in 388 out of 400 (97%), breast pain in 104 out of 388 (26.8%). Fifteen of 394 (3.8%) had second breast cancer, 4 (1%) had had ovarian cancer and 9 (2.3%) had had had other malignancy. History of breast cancer in first and second-degree relative was elicited in 41 out of 394 (10.4%). Ductal carcinoma NOS was commonest in 343 (88.2%), lobular carcinoma in 9(2.5%). Cases by T stage were T1 - 25(7.2%), T2 -130(37.4%), T3 - 96(27.6%), T4 - 87(25%). Of 322 cases, 187(58.1%) were ER positive and 175 (54.4%) PR positive. Her2 positive cases were 78 out of 322 (24.2%). Neo adjuvant and adjuvant chemotherapy mainly consisted of combinations of cyclophosphamide and doxorubicin [AC] +/- a taxane[AC→T] ( mainly by medical oncologists) or AC+ 5-FU [CAF] (mainly by clinical oncologists). Of 305 cases 272 (89.2%) completed adjuvant therapy, 8(2.6%) died during treatment. Median overall survival was 57.1 months (95% CI; 55.6 to 59.5 months). For metastatic disease, median PFS was worse for patients < 40 years. Conclusions: Pathology and biology mirrored global situation, over 75% of patients had non metastatic disease. A significant proportion of early disease patients did not complete treatment.

Pathologic characteristics of breast cancer with special emphasis on prevalence of triple-negative breast cancer from Kenya: A 4-year experience.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 35-35
Author(s):  
S. Sayed ◽  
Z. Moloo ◽  
S. Mukono ◽  
R. Wasike ◽  
R. R. Chauhan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Significant Proportion ◽  
Small Sample ◽  
University Hospital ◽  
Breast Cancers ◽  
Grade 3

35 Background: Previous sub classification of breast cancer in Kenya has been fraught by small sample size, non uniform staining methodology and lack of independent review. Triple Negative Breast Cancer (TNBC) is a “special interest” cancer since it represents a significant proportion of breast cancer patients and is associated with a poorer prognosis. We aimed to determine the estrogen receptor (ER), progesterone receptor (PR) and Her2/neu receptor characteristics of breast cancers and the prevalence of TNBC diagnosed at Aga Khan University Hospital, Nairobi (AKUHN) between 2007 to date. Methods: Slides and blocks of archived invasive breast cancers diagnosed at AKUHN were identified, retrieved and reviewed by two independent pathologists. Histological type, grade and pathological stage were documented. Representative sections from available blocks were stained for ER, PR, Her2 with appropriate internal controls. Scores for ER/PR were interpreted based on the ALLRED system, Her2 /neu scoring followed CAP guidelines. The initial 111 cases were validated and confirmed at Sunnybrook Health Sciences Centre, Toronto. Results: 456 cases of invasive breast cancers were diagnosed at AKUHN during the study period. 91% of cases were invasive ductal carcinomas (NOS).The rest were special types. 37% of the tumors were grade 3 and 63% were grade 2. Blocks for 318 of 456 cases were available for receptor analysis. 54% were ER and/or PR positive, with 52% of these in women < 50 yrs. 86% of the ER and/or PR positive tumors were grade 2. Only 12% were Her2/neu positive. Of the 318 cases studied, 111 (32%) were identified as TNBC. Median age was 53 yrs. 88% were grade 3. Conclusions: Invasive ductal carcinoma (NOS) was the most common breast cancer in our study. Nearly half of our cases were ER and/or PR positive and a third were TNBC. Both occurred predominantly in women less than 50 yrs. This represents the largest validated pathologic sub classification of breast cancer from a tertiary academic hospital in Kenya. Expansion of this study to encompass all breast cancers diagnosed in Kenya is underway.

Breast cancer in the elderly.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11506-e11506
Author(s):  
Dilek Erdem ◽  
Bahiddin Yilmaz ◽  
Fatih Mehmet Cilingir ◽  
Selim Kocasarac ◽  
Fatih Teker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Elderly Women ◽  
Ductal Carcinoma ◽  
Disease Status ◽  
The Elderly ◽  
Breast Cancer Patients ◽  
Abdominal Ultrasonography ◽  
Age Related ◽  
Patient Decision

e11506 Background: Breast cancer is one of the age-related tumors that accompany with population ageing and approximately 50 % of this disease occur in 65 years of age or older and also more than 30 % occur after age of 70. This study aims to examine characteristics of patients with breast cancer 65 years or older. Methods: The study was carried out on a series of 177 breast cancer patient followed up at our outpatient clinic who are 65 years or older chosen among 848 breast cancer patients during the period 1995-2012. Physical examination, annual chest x-ray, mammography, abdominal ultrasonography and bone scan were the tools to assess the disease status. SPSS 16 was used. Results: The mean age was 70.8 years old (range 65-85 years). There was only one patient whose age is older than 85 years. 85 % of histopathology was infiltratif ductal carcinoma. 83 % of patients underwent mastectomy while 92 % was performed axillary dissection. 56 % had node positivity and 54 % had 2 cm or bigger tumor. ER/PR status was both negative in 54 women (30 %) and both positive in 82 of them. Also cerbB2 was negative in most of the patients (70 %). At the diagnosis, 20 patients (11.3 %) had metastatic disease and 157 were without metastases. Totally 44 patients (32 %) had metastatic disease and most of them (29 patients) had bone disease. Only 52 did not have endocrine therapy with 48 % had tamoxifen as a part of hormonal therapy. Most of them received radiotherapy (54 %). DFS was within 7-182 months with a median of 54 months. PFS was between 2-60 months and patients had a median OS about 61 months. 30 patients died because several causes owing to ageing causes. Conclusions: Breast cancer is the most significant cancer of women and the screening modalities with adjuvant postoperative therapies have increased survival. Acute and chronic medical conditions, nutritional status, poly-pharmacy, level of activity, disease-spesific symptoms and patient decision all need to be taken into consideration. Both in early and advanced stages of the disease, quality of life and related aspects have critical importance in elderly women who have more limited life-expectancy. It is also essential that women with breast cancer 65 years and older be included in trials and that they be recommended the best therapies available.

scholarly journals Ductal Carcinoma In Situ with Diffuse Growth Distribution: A Potentially Lethal Subtype of Preinvasive Disease

2020 ◽  
Author(s):  
Thomas Joseph O'Keefe ◽  
Olivier Harismendy ◽  
Anne M Wallace
Keyword(s):  
Breast Cancer ◽  
Cancer Registry ◽  
Metastatic Disease ◽  
Ductal Carcinoma In Situ ◽  
Cumulative Incidence ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Bilateral Mastectomy ◽  
Growth Distribution

PURPOSE: The current trend in ductal carcinoma in situ (DCIS) research is towards treatment de-escalation. Problematically, prognostic indicators for patients at high risk of breast cancer mortality (BCM), rather than recurrence, have not been identified. We aim to identify prognostic factors for the development of metastatic disease and mortality. EXPERIMENTAL DESIGN: Patients diagnosed with DCIS in a local cancer registry as well as in the National Cancer Database (NCDB) and the Surveillance, Epidemiology and End Results (SEER) program were assessed for factors prognostic of metastatic disease, overall, and breast-cancer specific survival. Cox and competing risks regressions were developed. RESULTS: Among 5 patients who developed distant metastatic disease in the cancer registry, 3 had identifiable growth distribution; all 3 were diffuse type. None had in-breast invasive or DCIS recurrences before metastasis. In NCDB and SEER, cumulative incidence of any cause mortality (ACM) and BCM at 10 years was 12%/5.0% for diffuse lesions; 8%/3.6% for patients with microinvasive disease, 7.4%/2.3% for lesions >5 cm, 5.6%/1.4% for lesions 2-5 cm and 5.5%/1.5% for lesions <2 cm. Multivariate hazard ratios for ACM in NCDB and BCM in SEER were 2.0 and 5.3 (p=0.03 and 0.02, respectively). Among patients with diffuse lesions, cumulative incidence ACM at 10 years was 15.0% among those undergoing unilateral mastectomy vs. 2.5% among those undergoing bilateral mastectomy (p=0.11). CONCLUSION: Diffuse DCIS represents an uncommon but deadly subtype for whom treatment escalation, rather than de-escalation, is likely necessary. Further studies elucidating the mechanism of metastasis and best treatment course are needed.

Report on breast cancer care (BRECC) registry at the Kenyatta National Hospital, Nairobi, Kenya.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e12546-e12546 ◽  
Author(s):  
Nicolas Anthony Othieno-Abinya ◽  
Alice Musibi ◽  
Catherine Nyongesa ◽  
Raymond Omollo ◽  
Benjamin Njihia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Breast Cancer Care ◽  
National Hospital ◽  
Kenyatta National Hospital

A survey of cannabis use for symptom palliation in breast cancer patients by age and stage.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12108-12108
Author(s):  
Marisa C. Weiss ◽  
Meghan Buckley ◽  
Julianne Hibbs ◽  
Adam Leitenberger ◽  
Melissa Jenkins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Significant Proportion ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Patients ◽  
Medical Cannabis ◽  
Eligibility Criteria ◽  
Chi Square ◽  
Post Surgery

12108 Background: Most US states have legalized medical cannabis for the treatment of serious conditions, including cancer. It is not well known which symptoms breast cancer patients seek to control with cannabis. Methods: Members of the Breastcancer.org and Healthline communities were invited to participate in this survey between 12/16/2019 and 1/19/2020. Eligibility criteria included age ≥18 years, resident of the US and a breast cancer diagnosis within the past 5 years. Eligible respondent data were analyzed for the symptomatic profile of cannabis users. Symptoms were compared between two groups using a Chi-square test of independence. The survey was led by Socanna, conducted by Outcomes Insights, and supported by a grant from Ananda Health/Ecofibre. Results: Among the 832 respondents who completed screening, 725 met the eligibility criteria, and 612 (84%) completed the survey. The median age of respondents was 57 years, and 85% had non-metastatic disease An estimated 42% of respondents have used medical cannabis to treat symptoms or side effects of breast cancer. Medical cannabis users reported using cannabis to treat insomnia (70%), joint and muscle aches, discomfort, stiffness, or pain (59%), anxiety (57%), and stress (51%). The medical cannabis users less than 50-year-old were more likely to use cannabis to treat these symptoms than their over 50-year-old counterparts, however, the differences were not statistically significant. Medical cannabis users under age 50 used cannabis significantly more than over 50 to treat nausea/vomiting (58% vs 40%; p = 0.010) and inflammation (34% vs 20%; p = 0.021). Medical cannabis users with metastatic disease were more likely to use medical cannabis to treat chronic pain 60% vs 41%; p = 0.017) than non-metastatic users. Post-surgery patients were most likely to use cannabis for nerve pain; and those who were beyond treatment, for stress. Patients suffered an average of 5 symptoms. Conclusions: A significant proportion of breast cancer patients reported using cannabis to treat a combination of symptoms from their cancer and its treatment. Although younger patients are somewhat more likely to use this form of palliative management, older patients are suffering from the same symptoms and their use is nearly as high. More research is needed on the personalization of safe and effective symptomatic management with medical cannabis, for people of all ages, stages, and forms of treatment.

scholarly journals Survival Outcomes among Human Epidermal Growth Factor Receptor 2- (HER2-) Positive Breast Cancer Patients at Kenyatta National Hospital

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Gloria Tuwei ◽  
Amsalu Degu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Survival Outcomes ◽  
Breast Cancer Patients ◽  
National Hospital ◽  
Her2 Positive ◽  
Kenyatta National Hospital ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

Introduction. HER2-positive breast cancer is associated with poor outcomes and higher mortality rates than other breast cancer subtypes. The advent of trastuzumab has significantly changed the natural history of HER2-positive breast cancer. However, it is not an affordable treatment option in sub-Saharan African countries. Because of the expense, most patients in our setting do not receive trastuzumab for the optimal control of their disease. Additionally, there is a lack of comprehensive data about the survival outcomes of HER2-positive breast cancer patients in our setting. The present study was aimed at determining the survival outcomes among HER2-positive breast cancer patients at the Oncology Department of Kenyatta National Hospital. Methods. A hospital-based retrospective cohort design was used to evaluate the survival outcomes among patients with HER2-positive breast cancer treated from 1st January 2015 to 31st December 2019 at Kenyatta National Hospital. A total of 50 eligible HER2-positive breast cancer patients were included in the study. In the predesigned data abstraction tool, data were collected by reviewing the medical records of the patients. The data were entered and analyzed using the Statistical Package for the Social Sciences version 27 software. The mean survival time was estimated using Kaplan-Meier survival analysis. Results. The mean age was 45.44 ± 12.218  years, with a majority (80%) of the patients being below 60 years. Most patients (64%) had advanced-stage disease. The median follow-up time for patients with curative stages of breast cancer was 41 months, while the median follow-up time for those with the advanced incurable disease was 8.5 months. The 4-year survival rate was 62.5% for those curable-stage HER2-positive breast cancer compared to 5.6% for those with metastatic disease at presentation. Conclusion. The 4-year survival rate for both early-stage and advanced-stage HER2-positive breast cancer in our setting is suboptimal when compared to existing outcome data from health care systems where trastuzumab is more widely available.

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