Raharisolo Vololonantenaina C R, Rabarijaona L P, Rajemiarimoelisoa C, Rasendramino M, Migliani R
Institut Pasteur de Madagascar, BP 1274-101 Antananarivo, Madagascar.
Arch Inst Pasteur Madagascar. 2002;68(1-2):104-8.
Breast cancer is a great problem of public health all over the world. In developed countries, breast cancer represents the most common cancer in females. Its incidence is also increasing in developing country. In Madagascar, no data is available to estimate the real incidence and prevalence rates of breast cancer. However, the data at the Institut Pasteur de Madagascar can confirm the extent of the problem even if it is not at a national scale. The authors report the results of a retrospective study from histological examination at the Laboratory of pathological anatomy of the IPM, during 7 years. Among 2,337 cases of cancer, 16% (373) were breast cancer. Most of them were a female breast cancer (356 cases). The average age is 48 years old. 30% of the tumors were more than 2 cm in size, corresponding at least to the T2 stade from the International Union Against Cancer anatomoclinical classification. The current histological type is the infiltrating ductal carcinoma (80%), about 2/3 belong to the grade 3 of the Scarff-Bloom-Richardson histopronostical classification. Early diagnosis of the cancer is difficult because of the insufficiency of the sanitary infrastructure, particularly for cervical and breast cancers. A national policy for screening must be set up in order to decrease the rate of these invasive carcinomas. In the meantime, informing women and training all the medical staff is a priority. Recording all the data in Madagascar would be desirable.
乳腺癌是全球一个重大的公共卫生问题。在发达国家，乳腺癌是女性中最常见的癌症。其发病率在发展中国家也呈上升趋势。在马达加斯加，尚无数据可用于估计乳腺癌的实际发病率和患病率。然而，马达加斯加巴斯德研究所的数据即便不是全国范围的，也能证实该问题的严重程度。作者报告了一项在IPM病理解剖实验室进行的为期7年的组织学检查回顾性研究结果。在2337例癌症病例中，16%（373例）为乳腺癌。其中大多数是女性乳腺癌（356例）。平均年龄为48岁。30%的肿瘤大小超过2厘米，至少对应国际抗癌联盟解剖临床分类中的T2期。目前的组织学类型是浸润性导管癌（80%），约2/3属于斯卡夫-布卢姆-理查森组织学预后分类的3级。由于卫生基础设施不足，尤其是针对宫颈癌和乳腺癌的基础设施不足，癌症的早期诊断很困难。必须制定一项全国性的筛查政策，以降低这些浸润性癌的发病率。与此同时，对女性进行宣传并培训所有医务人员是当务之急。在马达加斯加记录所有数据是可取的。
