Two to nine year Review of Breast Conservation Therapy (BCT) for Breast Carcinoma: Clinico-Pathological features and Survival in a Single Centre in East Africa
Date of Award
Master of Medicine (MMed)
Prof. Ronald Wasike
Dr. Miriam Mutebi
Dr. Ahmed Komen
General Surgery (East Africa)
Introduction: Breast conservation therapy compares to mastectomy in terms of overall survival and disease free survival. However it’s utilization in most parts of the sub-Sahara Africa is minimal with various factors cited: patient preference, provider preference and adverse effects of or limited access to radiation therapy. The aim of this study was to determine the clinico-pathological profile and outcomes of breast cancer patients treated with breast conservation therapy or mastectomy at a single referral centre.
Methods: The Aga khan university hospital is one of the institutions in East Africa, where breast conservation therapy is practiced. We retrospectively analysed the details of breast cancer patients who underwent breast conservation therapy from the year 2008 to 2015 and compared this with patients who had undergone mastectomy during the same period.
Results: Ninety one patients who had breast conservation therapy and 187 patients who underwent mastectomy were included in this study. The following factors were correlated with the type of surgery: age <35, 35-50, >51 years, parity, grade, stage, histological subtype, receptor status, neo-adjuvant therapy, adjuvant therapy and re-excision rate. The majority of patients, 38.1% (n=106) had stage II breast cancer. Although there was no stage to stage comparison between the breast conservation group and the mastectomy group, patients who had breast conservation were likely to be younger, with tumour grade I or III and luminal A molecular subtype. There was no significant correlation with being nulliparous, grade II tumours, having received neoadjuvant chemotherapy or re-excision rates. Patients who had mastectomy were likely to be older with grade II breast cancer and had adjuvant chemotherapy.
Conclusion: The present study concluded that with proper pre-operative patient selection, breast conservation therapy has comparable clinico-pathological characteristics and outcomes to mastectomy.
Orerah, G. (2018). Two to nine year Review of Breast Conservation Therapy (BCT) for Breast Carcinoma: Clinico-Pathological features and Survival in a Single Centre in East Africa (Unpublished master's dissertation). Aga Khan University, East Africa.