Clinical and epidemiologic profile of breast cancer in Tanzania

Ashley M. Burson, Amr S. Soliman, Twalib A. Ngoma, Julius Mwaiselage, P. Ogweyo, Mohab S. Eissa, Subhojit Dey, Sofia D. Merajver

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: Breast cancer is a highly heterogeneous disease globally. Public health prevention measures require an understanding of the burden of breast cancer and its risk factors. The purpose of this study was to describe the clinical, pathologic, and epidemiologic characteristics of breast cancer patients in Tanzania. Methods: Data was abstracted from the medical records of all breast cancer patients attending Ocean Road Cancer Institute (ORCI) over a 2-year period from July 2007 to June 2009. Tumor tissue paraffin blocks were collected for all patients with available tissues for the determination of estrogen receptor (ER) and progesterone receptor (PR). Data for all patients was analyzed descriptively and by using unconditional logistic regression, by comparing early stage (ES), defined as stages I and II and late stage (LS), defined as stages III and IV patients to obtain odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Results: Among the 488 patients, stage was determined for 356 patients, 90.7% of whom presented in LS. Of the 57 tumor tissues, 49.1% were ER-/PR-. Patients with ulceration (OR = 4.97; 95% CI = 1.07, 23.04; p = 0.04) and peau d'orange (OR = 6.78; 95% CI = 1.48, 31.17; p = 0.01) were more likely to present in LS rather than ES. Male breast cancer accounted for 2.9% of all breast cancers and inflammatory breast cancer (IBC) comprised 4.3-5.5% of cases based on registered t4d diagnosis or the criteria of IBC signs, if t4d was not reported in the medical records. Conclusion: Most breast cancer patients in Tanzania are diagnosed at advanced disease stages with about half of the tumors being ER-/PR-. These data strongly support that reducing barriers to care, down-staging of disease at diagnosis, implementation of clinical guidelines for management of advanced cases, and palliative care are the four most essential factors that need to be addressed to reduce morbidity and mortality from breast cancer in Tanzania. Further research is needed to quantify the magnitude and molecular features of two relatively rare forms of breast cancer that may account for a greater proportion of the burden of breast cancer in Tanzania compared to the USA and Western Europe: male breast cancer and IBC.

Original languageEnglish (US)
Pages (from-to)33-41
Number of pages9
JournalBreast Disease
Volume31
Issue number1
DOIs
StatePublished - Dec 1 2010

Fingerprint

Tanzania
Breast Neoplasms
Inflammatory Breast Neoplasms
Progesterone Receptors
Estrogen Receptors
Male Breast Neoplasms
Odds Ratio
Confidence Intervals
Medical Records
Neoplasms
Case Management
Palliative Care
Oceans and Seas
Paraffin
Public Health
Logistic Models
Guidelines
Morbidity

Keywords

  • Breast cancer
  • Sub-Saharan Africa
  • Tanzania
  • epidemiology
  • inflammatory breast cancer
  • male breast cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Burson, A. M., Soliman, A. S., Ngoma, T. A., Mwaiselage, J., Ogweyo, P., Eissa, M. S., ... Merajver, S. D. (2010). Clinical and epidemiologic profile of breast cancer in Tanzania. Breast Disease, 31(1), 33-41. https://doi.org/10.3233/BD-2009-0296

Clinical and epidemiologic profile of breast cancer in Tanzania. / Burson, Ashley M.; Soliman, Amr S.; Ngoma, Twalib A.; Mwaiselage, Julius; Ogweyo, P.; Eissa, Mohab S.; Dey, Subhojit; Merajver, Sofia D.

In: Breast Disease, Vol. 31, No. 1, 01.12.2010, p. 33-41.

Research output: Contribution to journalArticle

Burson, AM, Soliman, AS, Ngoma, TA, Mwaiselage, J, Ogweyo, P, Eissa, MS, Dey, S & Merajver, SD 2010, 'Clinical and epidemiologic profile of breast cancer in Tanzania', Breast Disease, vol. 31, no. 1, pp. 33-41. https://doi.org/10.3233/BD-2009-0296
Burson AM, Soliman AS, Ngoma TA, Mwaiselage J, Ogweyo P, Eissa MS et al. Clinical and epidemiologic profile of breast cancer in Tanzania. Breast Disease. 2010 Dec 1;31(1):33-41. https://doi.org/10.3233/BD-2009-0296
Burson, Ashley M. ; Soliman, Amr S. ; Ngoma, Twalib A. ; Mwaiselage, Julius ; Ogweyo, P. ; Eissa, Mohab S. ; Dey, Subhojit ; Merajver, Sofia D. / Clinical and epidemiologic profile of breast cancer in Tanzania. In: Breast Disease. 2010 ; Vol. 31, No. 1. pp. 33-41.
@article{23f4e4bb8866424abbf5bb911759671a,
title = "Clinical and epidemiologic profile of breast cancer in Tanzania",
abstract = "Purpose: Breast cancer is a highly heterogeneous disease globally. Public health prevention measures require an understanding of the burden of breast cancer and its risk factors. The purpose of this study was to describe the clinical, pathologic, and epidemiologic characteristics of breast cancer patients in Tanzania. Methods: Data was abstracted from the medical records of all breast cancer patients attending Ocean Road Cancer Institute (ORCI) over a 2-year period from July 2007 to June 2009. Tumor tissue paraffin blocks were collected for all patients with available tissues for the determination of estrogen receptor (ER) and progesterone receptor (PR). Data for all patients was analyzed descriptively and by using unconditional logistic regression, by comparing early stage (ES), defined as stages I and II and late stage (LS), defined as stages III and IV patients to obtain odds ratios (ORs), 95{\%} confidence intervals (CIs), and P-values. Results: Among the 488 patients, stage was determined for 356 patients, 90.7{\%} of whom presented in LS. Of the 57 tumor tissues, 49.1{\%} were ER-/PR-. Patients with ulceration (OR = 4.97; 95{\%} CI = 1.07, 23.04; p = 0.04) and peau d'orange (OR = 6.78; 95{\%} CI = 1.48, 31.17; p = 0.01) were more likely to present in LS rather than ES. Male breast cancer accounted for 2.9{\%} of all breast cancers and inflammatory breast cancer (IBC) comprised 4.3-5.5{\%} of cases based on registered t4d diagnosis or the criteria of IBC signs, if t4d was not reported in the medical records. Conclusion: Most breast cancer patients in Tanzania are diagnosed at advanced disease stages with about half of the tumors being ER-/PR-. These data strongly support that reducing barriers to care, down-staging of disease at diagnosis, implementation of clinical guidelines for management of advanced cases, and palliative care are the four most essential factors that need to be addressed to reduce morbidity and mortality from breast cancer in Tanzania. Further research is needed to quantify the magnitude and molecular features of two relatively rare forms of breast cancer that may account for a greater proportion of the burden of breast cancer in Tanzania compared to the USA and Western Europe: male breast cancer and IBC.",
keywords = "Breast cancer, Sub-Saharan Africa, Tanzania, epidemiology, inflammatory breast cancer, male breast cancer",
author = "Burson, {Ashley M.} and Soliman, {Amr S.} and Ngoma, {Twalib A.} and Julius Mwaiselage and P. Ogweyo and Eissa, {Mohab S.} and Subhojit Dey and Merajver, {Sofia D.}",
year = "2010",
month = "12",
day = "1",
doi = "10.3233/BD-2009-0296",
language = "English (US)",
volume = "31",
pages = "33--41",
journal = "Breast Disease",
issn = "0888-6008",
publisher = "IOS Press",
number = "1",

}

TY - JOUR

T1 - Clinical and epidemiologic profile of breast cancer in Tanzania

AU - Burson, Ashley M.

AU - Soliman, Amr S.

AU - Ngoma, Twalib A.

AU - Mwaiselage, Julius

AU - Ogweyo, P.

AU - Eissa, Mohab S.

AU - Dey, Subhojit

AU - Merajver, Sofia D.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Purpose: Breast cancer is a highly heterogeneous disease globally. Public health prevention measures require an understanding of the burden of breast cancer and its risk factors. The purpose of this study was to describe the clinical, pathologic, and epidemiologic characteristics of breast cancer patients in Tanzania. Methods: Data was abstracted from the medical records of all breast cancer patients attending Ocean Road Cancer Institute (ORCI) over a 2-year period from July 2007 to June 2009. Tumor tissue paraffin blocks were collected for all patients with available tissues for the determination of estrogen receptor (ER) and progesterone receptor (PR). Data for all patients was analyzed descriptively and by using unconditional logistic regression, by comparing early stage (ES), defined as stages I and II and late stage (LS), defined as stages III and IV patients to obtain odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Results: Among the 488 patients, stage was determined for 356 patients, 90.7% of whom presented in LS. Of the 57 tumor tissues, 49.1% were ER-/PR-. Patients with ulceration (OR = 4.97; 95% CI = 1.07, 23.04; p = 0.04) and peau d'orange (OR = 6.78; 95% CI = 1.48, 31.17; p = 0.01) were more likely to present in LS rather than ES. Male breast cancer accounted for 2.9% of all breast cancers and inflammatory breast cancer (IBC) comprised 4.3-5.5% of cases based on registered t4d diagnosis or the criteria of IBC signs, if t4d was not reported in the medical records. Conclusion: Most breast cancer patients in Tanzania are diagnosed at advanced disease stages with about half of the tumors being ER-/PR-. These data strongly support that reducing barriers to care, down-staging of disease at diagnosis, implementation of clinical guidelines for management of advanced cases, and palliative care are the four most essential factors that need to be addressed to reduce morbidity and mortality from breast cancer in Tanzania. Further research is needed to quantify the magnitude and molecular features of two relatively rare forms of breast cancer that may account for a greater proportion of the burden of breast cancer in Tanzania compared to the USA and Western Europe: male breast cancer and IBC.

AB - Purpose: Breast cancer is a highly heterogeneous disease globally. Public health prevention measures require an understanding of the burden of breast cancer and its risk factors. The purpose of this study was to describe the clinical, pathologic, and epidemiologic characteristics of breast cancer patients in Tanzania. Methods: Data was abstracted from the medical records of all breast cancer patients attending Ocean Road Cancer Institute (ORCI) over a 2-year period from July 2007 to June 2009. Tumor tissue paraffin blocks were collected for all patients with available tissues for the determination of estrogen receptor (ER) and progesterone receptor (PR). Data for all patients was analyzed descriptively and by using unconditional logistic regression, by comparing early stage (ES), defined as stages I and II and late stage (LS), defined as stages III and IV patients to obtain odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Results: Among the 488 patients, stage was determined for 356 patients, 90.7% of whom presented in LS. Of the 57 tumor tissues, 49.1% were ER-/PR-. Patients with ulceration (OR = 4.97; 95% CI = 1.07, 23.04; p = 0.04) and peau d'orange (OR = 6.78; 95% CI = 1.48, 31.17; p = 0.01) were more likely to present in LS rather than ES. Male breast cancer accounted for 2.9% of all breast cancers and inflammatory breast cancer (IBC) comprised 4.3-5.5% of cases based on registered t4d diagnosis or the criteria of IBC signs, if t4d was not reported in the medical records. Conclusion: Most breast cancer patients in Tanzania are diagnosed at advanced disease stages with about half of the tumors being ER-/PR-. These data strongly support that reducing barriers to care, down-staging of disease at diagnosis, implementation of clinical guidelines for management of advanced cases, and palliative care are the four most essential factors that need to be addressed to reduce morbidity and mortality from breast cancer in Tanzania. Further research is needed to quantify the magnitude and molecular features of two relatively rare forms of breast cancer that may account for a greater proportion of the burden of breast cancer in Tanzania compared to the USA and Western Europe: male breast cancer and IBC.

KW - Breast cancer

KW - Sub-Saharan Africa

KW - Tanzania

KW - epidemiology

KW - inflammatory breast cancer

KW - male breast cancer

UR - http://www.scopus.com/inward/record.url?scp=78751515224&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78751515224&partnerID=8YFLogxK

U2 - 10.3233/BD-2009-0296

DO - 10.3233/BD-2009-0296

M3 - Article

C2 - 21109721

AN - SCOPUS:78751515224

VL - 31

SP - 33

EP - 41

JO - Breast Disease

JF - Breast Disease

SN - 0888-6008

IS - 1

ER -