Medicine and Medical Sciences

Most recently published works from across Nigeria and Africa point to a rising prevalence of breast cancer in these hitherto low incidence areas. The literature is also replete with studies on risk factors for the development of breast cancer amongst pre and post- menopausal women. Even though our center has also witnessed a rising trend in the incidence of breast cancer, not much work has been done to elucidate the risk factors associated with breast cancer in this sub region. This study is undertaken to determine the risk factors commonly associated with breast cancer in Sokoto, North-western Nigeria and to highlight the predominant receptor status of breast cancer in this region. A three-year retrospective study in which the case note of patients with histologically confirmed diagnosis of breast cancer between 2013 and 2015 were looked at. Parameters studied included demography, risk factors and receptor status. A total of ninety patients were seen in this study. Out of this, 88 were females, while 2 were males giving a female: male ratio of 44:1. The age range was 20 – 80 years. The mean age was 45.10 years. The median age was 43.00 years while modal age was 35.00 years. 70.45% (62) of the women with breast cancer were pre-menopausal while 29.55% (26) were post-menopausal. The mean BMI was 31.18. The main risk factors associated with breast cancer included, physical inactivity, 20.0%(18), high carbohydrate diet, 14.4%(13), high fatty diet, 12.2%(11), high intake of roasted beef (suya), 11.1%(10), hormonal contraceptive and cigarette smoking, 10.0% (9) each, family history, 8.9%(8) and alcohol comsumption,6.7%(6). Nulliparity, previous benign breast diseases and previous uterine cancer accounted for 3.3% (3), 2.2%(2) and 1.1%(1) respectively. Our centre started routine immunohistochemistry to determine receptor status of breast cancer in 2015. Analysis shows that 47.8% (22) of cancers were ER positive, 41.3%(19) PR positive, 39.1%(18) ER/PR positive, while 43.5%(20) were HER 2/neu positive. Immunohistochemical classification based on ER, PR and HER2 gene expression showed that 24%(11) were Luminal A(ER+, PR+,HER2-), 22%(10) Luminal B(ER+,PR+,HER2+), 26%(12) HER2 type(ER-,PR-,HER2+) while 28%(13) were Basal-like(Triple negative) tumours. Physical inactivity with high calorie (carbohydrate and fat), high protein diet appeared to be important risk factors for development of breast cancer in Sokoto, Nigeria. Majority, 28% (13) of the tumours were triple negative (basal like).
 

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