Gueye Serigne Modou Kane, Gueye Mamour, Coulbary Sophie Aminata, Diouf Alassane, Moreau Jean Charles
Clinique Gynécologique et Obstétricale CHU A, Le Dantec de Dakar, Sénégal.
Centre Hospitalier National de Pikine, Pikine, Sénégal.
Pan Afr Med J. 2016 Sep 6;25:3. doi: 10.11604/pamj.2016.25.3.3785. eCollection 2016.
At a time when innovative therapies in breast cancer multiply, poorer countries such as Senegal are still lag far behind in the overall management of this type of cancer. In Senegal, although the treatment of advanced breast cancer is now well codified, survival and morbidity outcomes are still mediocre in view of diagnostic delays and of sometimes expensive and poorly tolerated mutilating treatments become necessary. With respect to advanced cancers, the challenges will lie in building of palliative care centres and in developing multidisciplinary approaches to improve quality of life and to support patients. On the other hand, with respect to preclinical or potentially curable cancers, the challenges are immense given the importance of early detection, localisation and diagnosis (stereotactic or ultrasound guided biopsy) but also of precision surgery and of complete resection (indexing - excision ensuring a margin of healthy tissue and specimen radiograph) while minimizing complications such as those of classic dissection (sentinel lymph node biopsy). Our health structures are not always prepared to achieve these goals. This is a situational analysis of the contextual obstacles that still exist and add a burden on the overall management of breast cancer in Senegal.
在乳腺癌创新疗法不断涌现的时代，像塞内加尔这样的较贫穷国家在这类癌症的整体管理方面仍远远落后。在塞内加尔，尽管晚期乳腺癌的治疗如今已得到很好的规范，但鉴于诊断延误以及有时需要进行昂贵且耐受性差的致残性治疗，生存和发病结果仍然不尽人意。对于晚期癌症，挑战将在于建立姑息治疗中心以及发展多学科方法以提高生活质量并支持患者。另一方面，对于临床前或可能治愈的癌症，鉴于早期检测、定位和诊断（立体定向或超声引导活检）的重要性，以及精准手术和完全切除（索引切除确保有健康组织边缘和标本射线照片）同时将诸如经典解剖（前哨淋巴结活检）等并发症降至最低的重要性，挑战巨大。我们的卫生机构并不总是准备好实现这些目标。这是对塞内加尔乳腺癌整体管理中仍然存在并增加负担的背景障碍的情况分析。
