Carcinoma of the breast as seen at muhimbili medical centre a clinicopathological Study of 100 female patients

Abstract

This prospective study was conducted with an aim of finding out the clinico - pathological pattern of presentation of carcinoma of the female breast in 100 patients who presented at Muhimbili Medical Centre. It was found that a great proportion of patients suffering from the disease were young ladies below the age of 50 years. They constituted 50% of patients in the study. The median age was 44.9 years. This finding is in agreement with findings of previous studies conducted here in Tanzania and elsewhere in Africa South of the Sahara. It was however, in sharp contrasts with the age distribution of patients in the temperate climates where the median age is about 60 years. In this study as it is in such studies conducted elsewhere in Africa the age specific incidence falls sharply with advancing age, whereas in Europe and North America the incidence rates rise progressively with age. Most patients, (93%) presented in advanced, stage of the disease, that is stage III and IV independent of age of the patients. Early presentation was rare finding. The study revealed that there is considerable delay by patients to report to hospital from the moment they observed an abnormality in their breast, principally because they are ignorant about the disease and because the disease is painless. The study also recommends a research into women's attitudes

----- 105 towards their breast which might find out some hidden causes of this prominent delay in presentation. The health delivery system also contributes in the delay. Breast cancer in our environment is often associated with multiparity, prolonged lactation and breast feeding, and that oral contraceptives use is not a predominant risk factor among patients with breast cancer in our environment. Breast cancer occupies the left breast more than the right. The upper lateral quadrant is a preferential location of breast cancer in comparison to other quadrants. Nearly half of the patients examined are estrogen receptor (E.R) negative. This study recommends determination of these receptors for every breast cancer patients when ever this is possible. It recommends chemotherapy for those who are negative. Because tamoxifen has been shown to be active against some E.R. negative breast cancers, it can still be used imperatively on every patent when E.R. determination is not feasible. Histologically most tumours were of the invasive intraductal type (96%). Invasive lobular carcinomas constituted only 4%. Such a finding corresponds to findings elsewhere in the world. I '