Myelo-Suppressive Effects of Breast Cancer Chemotherapy in Nigerian Patients

Abstract

Breast cancer has become a major surgical burden in Nigeria as in other developing countries. Unlike in `Western societies where the tendency is towards earlier discovery when there are higher chances of cure, the disease still presents late in many African countries. In the absence of regular access to radiotherapy, chemotherapy is the major adjuvant treatment for pre-menopausal lesions in the third world. A prospective study of the myelo-suppresive effects of chemotherapy was undertaken in two hospitals by a single surgical practice between 1994 and 1997. Of the 64 patients treated within the period, 42 were evaluable as they completed the treatment and did not take concurrent native medication or radiotherapy. There was a depression of the blood indices with haematocrit being the least affected. Depression in neutrophil count though significant did not reach neutropaenic levels. Platelet depression was more marked towards the end of treatment. Twenty-five percent of the patients had dose-deferment of less than 2 weeks due to low haemoglobin or platelet count. It is concluded that with adequate monitoring cancer chemotherapy at recommended doses is feasible as outpatient treatment in third world countries (Nig J Surg Res 2000; 2:81-87) KEY WORDS: Breast cancer, Chemotherapy, Myelo-suppression