Vanderpuye V, Grover S, Hammad N, Simonds H, Olopade F, Stefan D C
National center for Radiotherapy and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, Ghana.
Hospital of University of Pennsylvania, Department of Radiation Oncology, (Botswana-UPENN program), 3400 Civic Center Blvd., Philadelphia, PA 19104 USA.
Infect Agent Cancer. 2017 Feb 14;12:13. doi: 10.1186/s13027-017-0124-y. eCollection 2017.
There is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities.
A search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms "breast cancer in Africa and developing countries". One hundred ninety were deemed appropriate.
Breast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities.
This review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.
关于非洲癌症管理面临的挑战以及改善治疗效果的尝试，相关信息有限。尽管南非和北非在应对乳腺癌负担方面资源更为充足，但所有非洲国家都存在类似的不良预后因素。在非洲，任何低收入和中等收入国家（LMIC）的乳腺癌患者五年总生存率都不超过60%。尽管在过去十年中取得了一些进展，但某些特征仍然相同，例如保乳治疗的可及性有限、药物获取不足、肿瘤专科医生数量少以及有害社会文化习俗的存在。这篇关于非洲乳腺癌管理的综述由在非洲执业或开展合作且亲身了解实际情况的非洲肿瘤学家撰写。
通过电子数据库检索1999年至2016年期间（PubMed/Medline、非洲期刊在线）所有英文或已翻译成英文的文献，检索词为“非洲和发展中国家的乳腺癌”。共筛选出190篇合适的文献。
与高收入国家相比，非洲乳腺癌患者的诊断年龄更早且分期更晚。三阴性癌症的患病率更高。护理和手术水平差、放疗可及性不足、基础和现代全身治疗手段匮乏等限制因素导致生存率较低。非洲在乳腺癌管理方面取得的积极进展包括更多地采用治疗指南、改善病理服务（包括免疫组织化学）、在非洲大陆各地扩充和升级放疗设备以及增加研究机会。
本综述是对非洲乳腺癌管理情况的更新，从具有当地经验的肿瘤学家的角度审视了非洲的流行病学、病理学、管理资源、治疗效果、研究情况及存在的局限性。
