Abstract
IntroductionBreast cancer is the second most diagnosed cancer worldwide. We aimed to depict the diagnostic approach as well as the epidemiological and clinical profile of patients with breast cancer at Potchefstroom regional hospital, South Africa.MethodsThis descriptive open-cohort study included patients with primary invasive breast cancer, confirmed by histology results and treated at the hospital from 01 January 2012 to 31 December 2018. Data such as demographics, patient history, histology, breast clinical findings, physical mass description and diagnostic investigations were captured from hospital registries and patient files.ResultOne-hundred thirty-eight patients (mean age 56.2 (SD: 14.4) (95% CI 54.6-59.7) years) met inclusion criteria. Most patients were female (98.6%), from African (67.4%) or Caucasian (23.9%) descent. Findings included mostly left-sided breast involvement (51.8%), lesions in the upper-outer quadrant (43.1%), extensions to the skin (25.6%, N = 39), and tumour size of 2 ≤ 5 cm (49.3%), or > 5 cm (39.1%). Most patients (57.9%, N = 135) were categorised as BIRADS-5, with a ductal pattern (89.6%) (p < 0.01). Patients mostly presented in stages II to IV of disease (89.1%; p < 0.05). Late-stage (stages III-IV) at time of diagnosis (n = 84) was significantly associated with mass location (p = 0.006; Cramér's V = 0.280), tumour size (p < 0.001, Cramér's V = 0.239), and skin changes (p = 0.027, Cramér's V = 0.492).ConclusionMost patients consulted at a late-stage of the disease, indicating a need for the promotion of breast awareness campaigns, early detection, and timeous referral.
Highlights
Breast cancer is the second most diagnosed cancer accounting for an estimated 2.1 million cases (11.6%) of all diagnosed cancers worldwide, and a leading cause of cancer-related morbidity and mortality with more than 626 000 deaths in 2018 [1]
A total of 138 patients (mean age 56.3 (SD: 14.4; 95% confidence intervals (CIs) (53.8-58.7)) had primary invasive breast cancer that was confirmed by histology results, admitted or treated at Potchefstroom Hospital from 1 January 2012 to 31 December 2018
We showed that most patients in our study consulted at late-stage of the disease, similar to recent studies conducted in peri-urban areas of South Africa [8,13], and other sub-Saharan African countries [14,15,16]
Summary
Breast cancer is the second most diagnosed cancer accounting for an estimated 2.1 million cases (11.6%) of all diagnosed cancers worldwide, and a leading cause of cancer-related morbidity and mortality with more than 626 000 deaths in 2018 [1]. In lowerto middle-income countries, breast cancer patients often present late in their diagnostic stage with advanced disease [6,7,8]. The goals of the South African National Department of Health's breast cancer control and management policy [11] include the improvement of survival, decreased time to presentation, patient diagnosis and treatment initiation. With the South African National Department of Health's policy goals at hand and the attentiveness of disparities regarding access to healthcare, the need for local/regional profiling of breast cancer patients derived. The aim of the study was to depict the diagnostic approach as well as the epidemiological and clinical profile of breast cancer in Potchefstroom regional hospital, South Africa. The study is, a snapshot of the current status in a rural area and should pave the way for improvement
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