Amir H, Kwesigabo G, Aziz M R, Kitinya J N
Department of Surgery, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
East Afr Med J. 1996 Feb;73(2):83-7.
This study investigated the profile of breast cancer patients in Tanzania during 1974-87 period. The results were compared with those of African patients in countries south of the Sahara. The maximum number of patients with breast cancer were seen in the sexually active age groups. In Sudan breast cancer was in leading position amongst all female cancers but with a lower proportion of women below 30 years, 6.4% (95% CI 5.3-7.6); x2 = 7.3 (p = 0.006). While in other sub-Saharan countries the disease ranked second to cervical cancer in frequency, but with a high proportion of patients below 30 years of age. This proportion was highest in Nigeria when compared with other African countries studied 14.7% (95% CI 8.9-22.3); x2 = 3.9 (p = 0.04). Mastectomy continues to be the treatment of choice for breast cancer in the sub Saharan countries despite the fact that this procedure is resented. Also that the Halstedian principle which governed the treatment of the disease for a century now has been disputed regarding its usefulness. The biological basis for adopting conservative surgery for breast cancer, the need for early detection and the oncogenesis of the disease are discussed.
本研究调查了1974 - 1987年期间坦桑尼亚乳腺癌患者的情况。研究结果与撒哈拉以南非洲国家的患者情况进行了比较。乳腺癌患者数量最多的是性活跃年龄组。在苏丹，乳腺癌在所有女性癌症中位居首位，但30岁以下女性所占比例较低，为6.4%（95%置信区间5.3 - 7.6）；卡方值 = 7.3（p = 0.006）。而在其他撒哈拉以南国家，该疾病的发病率仅次于宫颈癌，但30岁以下患者比例较高。与其他研究的非洲国家相比，这一比例在尼日利亚最高，为14.7%（95%置信区间8.9 - 22.3）；卡方值 = 3.9（p = 0.04）。尽管乳房切除术不受欢迎，但在撒哈拉以南国家，它仍然是乳腺癌的首选治疗方法。此外，支配该疾病治疗长达一个世纪的霍尔斯特德原则的实用性也受到了质疑。本文还讨论了采用乳腺癌保守手术的生物学基础、早期检测的必要性以及该疾病的肿瘤发生机制。
