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苏丹东部的乳腺癌负担:七年回顾性研究。

Breast cancer burden in eastern Sudan: seven-year retrospective study.

作者信息

Ahmed Ahmed Balla M, Alrawa Salma, Yeddi Ahmed A, Alfadul Esraa S A, Allah Hind Mohi Aldin Abd, Ahmed Muhannad Bushra Masaad

机构信息

Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan.

East Oncology Center, Ministry of Health, Gadarif 11111, Sudan.

出版信息

Ecancermedicalscience. 2024 May 21;18:1704. doi: 10.3332/ecancer.2024.1704. eCollection 2024.

Abstract

BACKGROUND

Breast cancer (BC) is prevalent in Sudan, yet data on its epidemiology in Eastern Sudan is limited. This study aims to provide insights into the demographic and clinicopathologic features of BC patients treated at the East Oncology Centre (EOC) in Gadarif State, Eastern Sudan. Furthermore, we aim to identify the factors that contribute to a late-stage diagnosis.

METHODS

This cross-sectional study included patients diagnosed with BC and treated in the EOC between 2016 and 2022. Data obtained from medical records were analysed using R software, with descriptive statistics and multiple logistic regressions applied to determine determinants of advanced-stage presentation. A -value < 0.05 was considered statistically significant.

RESULTS

Among the 394 patients studied, the majority were women (96%), married (66%) and from rural areas (43%). The peak years for BC diagnoses were 2018 and 2022, with a median age at diagnosis of 48 years. A family history of cancer was reported by 20% of patients. Clinical stages were distributed as follows: I (1.6%), II (17%), III (50%) and IV (32%). Twenty-five percent tested positive for human epidermal growth factor receptor 2, while 73% tested negative and 43% had triple-negative BC. Modified radical mastectomy was performed in 47% of patients, with 21% undergoing breast-conserving surgery. Treatment rates were 38% for radiotherapy, 84% for chemotherapy and 46% for hormonal therapy. Higher grade BC and lower education levels were associated with advanced-stage presentation, while a family history of cancer reduced the risk of advanced-stage disease (OR: 0.38, 95% CI: 0.18-0.78).

CONCLUSION

The study found that females in East Sudan often present at a young age and advanced stage, with a significant prevalence of triple-negative BC. Notably, family cancer history exhibited a protective effect against advanced-stage presentation, while grade 3 cancer was positively associated with advanced disease.

摘要

背景

乳腺癌(BC)在苏丹很常见,但关于其在苏丹东部流行病学的数据有限。本研究旨在深入了解在苏丹东部加达里夫州东部肿瘤中心(EOC)接受治疗的乳腺癌患者的人口统计学和临床病理特征。此外,我们旨在确定导致晚期诊断的因素。

方法

这项横断面研究纳入了2016年至2022年间在EOC被诊断为乳腺癌并接受治疗的患者。从医疗记录中获取的数据使用R软件进行分析,应用描述性统计和多重逻辑回归来确定晚期表现的决定因素。P值<0.05被认为具有统计学意义。

结果

在研究的394名患者中,大多数为女性(96%)、已婚(66%)且来自农村地区(43%)。乳腺癌诊断的高峰年份是2018年和2022年,诊断时的中位年龄为48岁。20%的患者报告有癌症家族史。临床分期分布如下:I期(1.6%)、II期(17%)、III期(50%)和IV期(32%)。25%的患者人表皮生长因子受体2检测呈阳性,73%检测呈阴性,43%为三阴性乳腺癌。47%的患者接受了改良根治性乳房切除术,21%接受了保乳手术。放疗治疗率为38%,化疗为84%,激素治疗为46%。高分级乳腺癌和低教育水平与晚期表现相关,而癌症家族史降低了晚期疾病的风险(比值比:0.38,95%置信区间:0.18 - 0.78)。

结论

该研究发现苏丹东部的女性通常在年轻时就出现晚期症状,三阴性乳腺癌的患病率很高。值得注意的是,癌症家族史对晚期表现具有保护作用,而3级癌症与晚期疾病呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d9c/11254413/47d8ff97a505/can-18-1704fig1.jpg

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