Department of Oncology, Stockholm South General Hospital, Stockholm, Sweden.
Mubende Regional Referral Hospital, Mubende, Uganda.
PLoS One. 2019 Jul 11;14(7):e0219601. doi: 10.1371/journal.pone.0219601. eCollection 2019.
Breast cancer is the most common cancer in women worldwide. Considerable funding and efforts are invested in breast cancer research and healthcare, but only a fraction of this reaches women and healthcare systems in low income countries. Surgical treatment is an essential part of breast cancer care, but access to surgery is in general very limited in low income countries such as Uganda. In this study, the previously unknown nationwide rate of breast cancer surgery was investigated.
This was a multicenter, retrospective study, investigating breast cancer surgery in the public healthcare system in Uganda. Data were collected from operating theater registries at primary, secondary and tertiary level healthcare centres throught the country, including 14 general hospitals, the 14 regional referral hospitals and the national referral hospital. Patients who underwent major surgery for breast cancer at these hospitals during 2013 and 2014 were included. The number of breast cancer procedures performed, geographical variation, level of healthcare staff performing surgery and patient characteristics were investigated. After correction for missing data, a total of 137 breast cancer procedures were performed each year within the public healthcare system, corresponding to 5.7% of the breast cancer incidence in the country at that time. Most procedures (n = 161, 59.0%) were performed at the national referral hospital by qualified surgeons. Many of the patients were young; 30.1% being less than 40 years old. The proportion of male breast cancers in the study was large (6.2%).
The rate of breast cancer surgery in Uganda is minimal and in several parts of the country breast cancer surgery is not performed at all. More resources must be directed towards breast cancer in low income countries such as Uganda. The fact that the patients were young calls for further research, prevention and treatment specifically targeting young women in the study setting.
乳腺癌是全世界女性最常见的癌症。大量资金和精力投入到乳腺癌研究和医疗保健中，但只有一小部分惠及低收入国家的妇女和医疗保健系统。手术治疗是乳腺癌治疗的重要组成部分，但在像乌干达这样的低收入国家，手术机会通常非常有限。在这项研究中，调查了以前未知的全国范围内乳腺癌手术率。
这是一项多中心、回顾性研究，调查了乌干达公共医疗体系中的乳腺癌手术情况。数据来自全国各级医疗中心（包括 14 家综合医院、14 家区域转诊医院和国家转诊医院）的手术室登记处。2013 年和 2014 年期间，在这些医院接受乳腺癌主要手术的患者被纳入研究。调查了手术数量、地理差异、手术医疗人员水平和患者特征。在纠正数据缺失后，每年在公共医疗体系中总共进行了 137 例乳腺癌手术，相当于当时该国乳腺癌发病率的 5.7%。大多数手术（n = 161，59.0%）由合格的外科医生在国家转诊医院进行。许多患者都很年轻，30.1%的患者年龄小于 40 岁。研究中男性乳腺癌的比例很大（6.2%）。
乌干达乳腺癌手术率极低，该国部分地区根本没有进行乳腺癌手术。必须向乌干达等低收入国家的乳腺癌投入更多资源。患者年轻的事实呼吁针对研究环境中的年轻女性进行进一步的研究、预防和治疗。
