Sutter Stephanie A, Slinker Aaron, Balumuka Deo Darius, Mitchell Katrina B
, Weill Cornell Medical College; , New York University, New York, NY; , Mbarara University of Science and Technology, Mbarara, Uganda; and , The University of Texas MD Anderson Cancer Center, Houston, TX.
J Glob Oncol. 2016 Jul 6;3(2):162-168. doi: 10.1200/JGO.2016.003095. eCollection 2017 Apr.
Breast cancer has emerged as a leading cancer among women in Africa, necessitating improved understanding of its management across the continent. Although previous studies have described regional trends in therapy, this review aims to summarize continent-wide management and focus specifically on surgical interventions. Current literature shows that the rates of surgery, chemotherapy, and radiation therapy vary across different countries and institutions, indicating the need for greater use of standardized cancer treatment guidelines. Surgery, primarily modified radical mastectomy, is the most common form of therapy described. When chemotherapy is offered, the limited availability and cost of treatment lead to high rates of interruption and premature termination of cycles. Few patients have access to radiation or hormonal therapy because these treatments are not available in many countries. Significant delays in seeking treatment are common and contribute to patients presenting with advanced disease. Although limited infrastructure favors surgical management, interventions to improve early detection behavior, provide timely referrals to medical care, and initiate early treatment with access to clinically justified neo-adjuvant and adjuvant therapy are key to improving prognosis.
乳腺癌已成为非洲女性中主要的癌症类型，因此有必要加深对整个非洲大陆乳腺癌治疗的了解。尽管此前的研究描述了治疗的区域趋势，但本综述旨在总结整个非洲大陆的治疗情况，并特别关注手术干预。当前文献表明，不同国家和机构的手术、化疗及放疗率各不相同，这表明需要更多地使用标准化癌症治疗指南。手术，主要是改良根治性乳房切除术，是描述最多的治疗方式。当提供化疗时，治疗的有限可及性和成本导致化疗周期中断和提前终止的比例很高。很少有患者能够接受放疗或激素治疗，因为许多国家无法提供这些治疗。寻求治疗的显著延迟很常见，这导致患者就诊时已处于疾病晚期。尽管有限的基础设施有利于手术治疗，但改善早期检测行为、及时转诊至医疗护理以及开展可获得临床合理新辅助和辅助治疗的早期治疗等干预措施，是改善预后的关键。
