Lopes Lygia Vieira, Miguel Fernando, Freitas Helga, Tavares António, Pangui Salvador, Castro Clara, Lacerda Gonçalo Forjaz, Longatto-Filho Adhemar, Weiderpass Elisabete, Santos Lúcio Lara
Sagrada Esperança Clinic, Luanda, Angola.
Angolan Institute of Cancer Control, Luanda, Angola.
BMC Health Serv Res. 2015 Oct 15;15:471. doi: 10.1186/s12913-015-1092-9.
It is expected that, by 2020, 15 million new cases of cancer will occur every year in the world, one million of them in Africa. Knowledge of cancer trends in African countries is far from adequate, and improvements in cancer prevention efforts are urgently needed. The aim of this study was to characterize breast cancer clinically and pathologically at presentation in Luanda, Angola; we additionally provide quality information that will be useful for breast cancer care planning in the country.
Data on breast cancer cases were retrieved from the Angolan Institute of Cancer Control, from 2006 to 2014. For women diagnosed in 2009 (5-years of follow-up), demographic, clinical and pathological information, at presentation, was collected, namely age at diagnosis, parity, methods used for pathological diagnoses, tumor pathological characteristics, stage of disease and treatment. Descriptive statistics were performed.
The median age of women diagnosed with breast cancer in 2009 was 47 years old (range 25-89). The most frequent clinical presentation was breast swelling with axillary lymph nodes metastasis (44.9 %), followed by a mass larger than 5 cm (14.2 %) and lump (12.9 %). Invasive ductal carcinoma was the main histologic type (81.8 %). Only 10.1 % of cancer cases had a well differentiated histological grade. Cancers were diagnosed mostly at advanced stages (66.7 % in stage III and 11.1 % in stage IV).
In this study, breast cancer was diagnosed at a very advanced stage. Although it reports data from a single cancer center in Luanda, Angola it reinforces the need for early diagnosis and increasing awareness. According to the main challenges related to breast cancer diagnosis and treatment herein presented, we propose a realistic framework that would allow for the implementation of a breast cancer care program, built under a strong network based on cooperation, teaching, audit, good practices and the organization of health services.
Angola needs urgently a program for early diagnosis of breast cancer.
预计到2020年,全球每年将出现1500万新增癌症病例,其中100万在非洲。非洲国家对癌症趋势的了解远远不够,迫切需要加强癌症预防工作。本研究的目的是对安哥拉罗安达市就诊时的乳腺癌进行临床和病理特征分析;此外,我们还提供了高质量信息,这将有助于该国乳腺癌护理规划。
从安哥拉癌症控制研究所检索2006年至2014年乳腺癌病例数据。对于2009年诊断的女性(随访5年),收集了就诊时的人口统计学、临床和病理信息,即诊断年龄、产次、病理诊断方法、肿瘤病理特征、疾病分期和治疗情况。进行了描述性统计分析。
2009年诊断为乳腺癌的女性中位年龄为47岁(范围25 - 89岁)。最常见的临床表现是乳腺肿胀伴腋窝淋巴结转移(44.9%),其次是直径大于5厘米的肿块(14.2%)和肿物(12.9%)。浸润性导管癌是主要组织学类型(81.8%)。只有10.1%的癌症病例组织学分级为高分化。癌症大多在晚期诊断(III期占66.7%,IV期占11.1%)。
在本研究中,乳腺癌在非常晚期才被诊断出来。尽管它报告的是安哥拉罗安达市单个癌症中心的数据,但它强化了早期诊断和提高认识的必要性。根据本文提出的与乳腺癌诊断和治疗相关的主要挑战,我们提出了一个切实可行的框架,该框架将允许实施一个乳腺癌护理计划,该计划建立在基于合作、教学、审计、良好实践和卫生服务组织的强大网络基础之上。
安哥拉迫切需要一个乳腺癌早期诊断计划。