Background: Breast cancer mortality remains high in the majority of developing countries. The Ministry of Health has established two population-based cancer registries in Benin: the first one in Cotonou in 2014 and the second one in Parakou in 2017. However, there is a scarcity of data on breast cancer survival and prognosis in Benin Republic. Objective: This study sought to investigate epidemiological, diagnostic, and survival aspects of breast cancer in Parakou, based on data from its population-based cancer registry from 2017 to 2021. Method: For descriptive and analytical purposes, we used a retrospective cohort design. From January 24, 2022 to August 31, 2022, data were collected in all health facilities covered by the Parakou population-based cancer registry using an individual questionnaire. Survival and prognosis analysis were performed using KAPLAN MEIER method and David COX proportional hazard model respectively. Result: A total of 81 patients have been included in this study. The incidence rate of breast cancer in Parakou was 17.5 per 100,000 person-years with a mortality rate of 2.76 per 100,000 person-years. The median age at diagnosis was 44.50 years with extremes ranging from 19 to 76 years and a predominance of 40 - 50 years age group. The median survival time was estimated at 30 months with an overall 5-year survival of 47%. Young age at diagnosis (p-value = 0.002) and advanced stage at diagnosis (p-value = 0.000) had a negative impact on survival in women. The combination of surgery and chemotherapy improved survival (p-value = 0.018). Conclusion: Breast cancer is still a public health issue in Parakou. It comes out mandatory that resources be made available to make screening, early diagnosis and appropriate treatment of breast cancer affordable.
References
[1]
Kalluri, R. and Zeisberg, M. (2006) Fibroblasts in Cancer. Nature Reviews Cancer, 6, 392-401. https://doi.org/10.1038/nrc1877
[2]
Sung, H., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. https://doi.org/10.3322/caac.21660
[3]
Egue, M., et al. (2019) Cancer Incidence in Cotonou (Benin), 2014-2016: First Results from the Cancer Registry of Cotonou. Cancer Epidemiology, 59, 46-50. https://doi.org/10.1016/j.canep.2019.01.006
[4]
Anderson, B.O., et al. (2008) Guideline Implementation for Breast Healthcare in Low-Income and Middle-Income Countries: Overview of the Breast Health Global Initiative Global Summit 2007. Cancer, 113, 2221-2243. https://doi.org/10.1002/cncr.23844
[5]
Toure, M., et al. (2013) Factors Linked to Late Diagnosis in Breast Cancer in Sub-Saharan Africa: Case of Côte d’Ivoire. Gynécologie, Obstétrique et Fertilité, 41, 696-700. https://doi.org/10.1016/j.gyobfe.2013.08.019
[6]
Carlson, R.W., et al. (2016) NCCN Framework for Resource Stratification: A Framework for Providing and Improving Global Quality Oncology Care. Journal of the National Comprehensive Cancer Network, 14, 961-969. https://doi.org/10.6004/jnccn.2016.0103
[7]
Barker, C. (2009) The Mean, Median, and Confidence Intervals of the Kaplan-Meier Survival Estimate—Computations and Applications. The American Statistician, 63, 78-80. https://doi.org/10.1198/tast.2009.0015
[8]
Somes, G.W. (1986) The Generalized Mantel-Haenszel Statistic. The American Statistician, 40, 106-108. https://doi.org/10.1080/00031305.1986.10475369
[9]
Gehan, E.A. (1965) A Generalized Wilcoxon Test for Comparing Arbitrarily Singly-Censored Samples. Biometrika, 52, 203. https://doi.org/10.1093/biomet/52.1-2.203
[10]
Tarone, R.E. and Ware, J. (1977) On Distribution-Free Tests for Equality of Survival Distributions. Biometrika, 64, 156-160. https://doi.org/10.1093/biomet/64.1.156
[11]
Cox, D.R. (1972) Regression Models and Life-Tables. Journal of the Royal Statistical Society: Series B (Methodological), 34, 187-202. https://doi.org/10.1111/j.2517-6161.1972.tb00899.x
[12]
Institut National des Cancers (2022) Panorama des cancers en France. https://www.e-cancer.fr/content/download/336357/4805630/file/[email protected]
[13]
Statistics Canada (2015) Table 13-10-0109-01 Cancer Incidence, by Selected Sites of Cancer and Sex, Three-Year Average, Canada, Provinces, Territories and Health Regions (2015 Boundaries).
[14]
Wiseman, M. (2008) The Second World Cancer Research Fund/American Institute for Cancer Research Expert Report. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective: Nutrition Society and BAPEN Medical Symposium on “Nutrition Support in Cancer Therapy”. Proceedings of the Nutrition Society, 67, 253-256. https://doi.org/10.1017/S002966510800712X
[15]
Thomas, A.S., et al. (2017) Breast Cancer in Ghana: Demonstrating the Need for Population-Based Cancer Registries in Low- and Middle-Income Countries. Journal of Global Oncology, 3, 765-772. https://doi.org/10.1200/JGO.2016.006098
[16]
Kantelhardt, E.J., et al. (2014) Breast Cancer Survival in Ethiopia: A Cohort Study of 1,070 Women: Breast Cancer Survival in Ethiopia. International Journal of Cancer, 135, 702-709. https://doi.org/10.1002/ijc.28691
[17]
Balekouzou, A., et al. (2018) Histo-Epidemiological Profile of Breast Cancers among Women in the Central African Republic: About 174 Cases. BMC Cancer, 18, Article No. 387. https://doi.org/10.1186/s12885-018-4256-2
[18]
Lopes, L.V., et al. (2015) Stage at Presentation of Breast Cancer in Luanda, Angola—A Retrospective Study. BMC Health Services Research, 15, Article No. 471. https://doi.org/10.1186/s12913-015-1092-9
[19]
Gnangnon, F., et al. (2020) Âge du diagnostic des cancers du sein en République du Bénin (Afrique de l’Ouest): Pouvons-nous encore appliquer les standards occidentaux en matière de dépistage? Revue d’épidémiologie et de Santé Publique, 68, S101. https://doi.org/10.1016/j.respe.2020.03.027
[20]
Merviel, P., et al. (2011) Existe-t-il encore des facteurs de risque de survenue d’un cancer du sein? Gynécologie Obstétrique & Fertilité, 39, 486-490. https://doi.org/10.1016/j.gyobfe.2010.10.015
[21]
Ndamba, J.P., et al. (2015) Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas. The Pan African Medical Journal, 21, 2893-2917. https://doi.org/10.11604/pamj.2015.21.242.7269
[22]
Brinton, L.A., et al. (2014) Breast Cancer in Sub-Saharan Africa: Opportunities for Prevention. Breast Cancer Research and Treatment, 144, 467-478. https://doi.org/10.1007/s10549-014-2868-z
[23]
Essiben, F., et al. (2013) Diagnosis and Treatment of Breast Cancer in Cameroon: A Series of 65 Cases. Mali Medical, 28, 1-5. https://doi.org/10.11604/pamj.2020.37.41.21336
[24]
El Fouhi, M., et al. (2020) Profil épidémiologique et anatomopathologique du cancer de sein au CHU Ibn Rochd, Casablanca. The Pan African Medical Journal, 37, Article No. 41.
[25]
Darré, et al. (2013) Profil histo-épidémiologique des cancers du sein. A propos de 450 cas observés au CHU de Lomé. Médecine d’Afrique Noire, 60, 53-58.
[26]
Ranaivomanana, M., et al. (2021) Aspects épidémio-cliniques des cancers du sein au service d’oncologie de Fianarantsoa, Madagascar de 2011 à 2018. The Pan African Medical Journal, 38, Article No. 264. https://doi.org/10.11604/pamj.2021.38.264.20031
[27]
Gnangnon, F., et al. (2021) étude de la survie et des facteurs pronostiques du cancer du sein chez la femme dans deux hôpitaux de référence au Sud du Bénin. Revue d’épidémiologie et de Santé Publique, 69, S69-S70. https://doi.org/10.1016/j.respe.2021.04.119
[28]
Gebretsadik, A., et al. (2021) Epidemiological Trends of Breast Cancer in Southern Ethiopia: A Seven-Year Retrospective Review. Cancer Control, 28. https://doi.org/10.1177/10732748211055262
[29]
Olaogun, J.G., et al. (2020) Socio-Demographic, Pattern of Presentation and Management Outcome of Breast Cancer in a Semi-Urban Tertiary Health Institution. The Pan African Medical Journal, 36, Article No. 363. https://doi.org/10.11604/pamj.2020.36.363.17866
[30]
Somé, et al. (2022) Breast Cancer in Bobo-Dioulasso, Burkina Faso: Management Outcomes. Oncologie, 24, 173-184. https://doi.org/10.32604/oncologie.2022.021250
[31]
Unger-Saldaña, K. (2014) Challenges to the Early Diagnosis and Treatment of Breast Cancer in Developing Countries. WJCO, 5, 465. https://doi.org/10.5306/wjco.v5.i3.465
[32]
The ICBP Module 1 Working Group 20, et al. (2013) Breast Cancer Survival and Stage at Diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000-2007: A Population-Based Study. British Journal of Cancer, 108, 1195-1208. https://doi.org/10.1038/bjc.2013.6
[33]
Ben Fatma, L., et al. (2018) What Could Be the Reasons of Late Diagnosis of Breast Cancer in Tunisia? La Tunisie Médicale, 96, 665-671.
[34]
Agodirin, O., et al. (2021) Determinants of Delayed Presentation and Advanced-Stage Diagnosis of Breast Cancer in Africa: A Systematic Review and Meta-Analysis. Asian Pacific Journal of Cancer Prevention, 22, 1007-1017. https://doi.org/10.31557/APJCP.2021.22.4.1007
[35]
Getachew, S., et al. (2020) Perceived Barriers to Early Diagnosis of Breast Cancer in South and Southwestern Ethiopia: A Qualitative Study. BMC Women’s Health, 20, Article No. 38. https://doi.org/10.1186/s12905-020-00909-7
[36]
McKenzie, F., et al. (2018) Drivers of Advanced Stage at Breast Cancer Diagnosis in the Multicountry African Breast Cancer—Disparities in Outcomes (ABC-DO) Study: Drivers of Advanced Stage at Breast Cancer Diagnosis. International Journal of Cancer, 142, 1568-1579. https://doi.org/10.1002/ijc.31187
[37]
Sahraoui, G., et al. (2017) Profil anatomopathologique du cancer du sein dans le cap bon tunisien. The Pan African Medical Journal, 26, Article No. 11. https://doi.org/10.11604/pamj.2017.26.11.11382
[38]
Kohler, R. (2015) Pathologically Confirmed Breast Cancer in Malawi: A Descriptive Study: Clinical Profile of Breast Cancer. Malawi Medical Journal, 27, 10-12. https://doi.org/10.4314/mmj.v27i1.3
[39]
Ben Gobrane, H., et al. (2007) Breast Cancer Prognosis in Salah Azaiez Institute of Cancer, Tunis. Eastern Mediterranean Health Journal, 13, 309-318.
[40]
Guendouz, et al. (2011) Cancer du sein de la femme de moins de 35 ans: étude rétrospective à propos de 612 cas. Société française de sénologie et de pathologie mammaire La Lettre du sénologue, 52.
[41]
Aka, E., et al. (2021) Expérience africaine monocentrique de la prise en charge personnalisée des cancers du sein à Abidjan: Défis et perspectives. Gynécologie Obstétrique Fertilité & Sénologie, 49, 684-690. https://doi.org/10.1016/j.gofs.2021.03.001
[42]
Newman, L.A. and Kaljee, L.M. (2017) Health Disparities and Triple-Negative Breast Cancer in African American Women: A Review. JAMA Surgery, 152, 485-493. https://doi.org/10.1001/jamasurg.2017.0005
[43]
Sturtz, L.A., et al. (2014) Outcome Disparities in African American Women with Triple Negative Breast Cancer: A Comparison of Epidemiological and Molecular Factors between African American and Caucasian Women with Triple Negative Breast Cancer. BMC Cancer, 14, Article No. 62. https://doi.org/10.1186/1471-2407-14-62
[44]
Dean, S.J.R. and Rhodes, A. (2014) Triple Negative Breast Cancer: The Role of Metabolic Pathways. The Malaysian Journal of Pathology, 36, 155-162.
[45]
Raina, V. (2014) Triple-Negative Breast Cancer: An Institutional Analysis. Indian Journal of Cancer, 51, 163-166. https://doi.org/10.4103/0019-509X.138275
[46]
Erić, I. (2018) Breast Cancer in Young Women: Pathologic and Immunohistochemical Features. Acta Clinica Croatica, 57, 497-501. https://doi.org/10.20471/acc.2018.57.03.13
[47]
Zaki, H.M., et al. (2013) Profil épidémiologique et anatomopathologique du cancer du sein au Niger. Journal Africain du Cancer, 5, 185-191. https://doi.org/10.1007/s12558-013-0274-9
[48]
Spruessel, A., et al. (2004) Tissue Ischemia Time Affects Gene and Protein Expression Patterns within Minutes Following Surgical Tumor Excision. BioTechniques, 36, 1030-1037. https://doi.org/10.2144/04366RR04
[49]
Nielsen, T.O., et al. (2021) Assessment of Ki67 in Breast Cancer: Updated Recommendations from the International Ki67 in Breast Cancer Working Group. JNCI: Journal of the National Cancer Institute, 113, 808-819. https://doi.org/10.1093/jnci/djaa201
[50]
Foerster, M., et al. (2019) Inequities in Breast Cancer Treatment in Sub-Saharan Africa: Findings from a Prospective Multi-Country Observational Study. Breast Cancer Research, 21, Article No. 93. https://doi.org/10.1186/s13058-019-1174-4
[51]
Joko-Fru, W.Y., et al. (2021) Breast Cancer Diagnostics, Therapy, and Outcomes in Sub-Saharan Africa: A Population-Based Registry Study. Journal of the National Comprehensive Cancer Network, 19, 75-85. https://doi.org/10.6004/jnccn.2021.7011
[52]
Mahjoub, N., et al. (2021) Epidemiological and Anatomopathological Profile of Breast Cancer in the Region of North-West of Tunisia. La Tunisie Médicale, 99, 441-448.
[53]
Gnangnon, F., et al. (2020) Profil épidémiologique, moléculaire et pronostic du cancer du sein au sud de la République du Bénin. Revue d’épidémiologie et de Santé Publique, 68, S138. https://doi.org/10.1016/j.respe.2020.03.077
[54]
Zingue, S., et al. (2021) Epidemiological and Clinical Profile, and Survival of Patients Followed for Breast Cancer between 2010 and 2015 at the Yaounde General Hospital, Cameroon. The Pan African Medical Journal, 39, Article No. 182. https://doi.org/10.11604/pamj.2021.39.182.26866
[55]
Galukande, M., et al. (2015) Breast Cancer Survival Experiences at a Tertiary Hospital in Sub-Saharan Africa: A Cohort Study. World Journal of Surgical Oncology, 13, 220. https://doi.org/10.1186/s12957-015-0632-4
[56]
Sledge, G.W. (2014) Past, Present, and Future Challenges in Breast Cancer Treatment. JCO, 32, 1979-1986. https://doi.org/10.1200/JCO.2014.55.4139
[57]
Patel, T.A., et al. (2014) Dual HER2 Blockade: Preclinical and Clinical Data. Breast Cancer Research, 16, Article No. 419. https://doi.org/10.1186/s13058-014-0419-5
[58]
Criscitiello, C., et al. (2014) Immune Approaches to the Treatment of Breast Cancer, around the Corner? Breast Cancer Research, 16, 204. https://doi.org/10.1186/bcr3620
[59]
Adesina, A., et al. (2013) Improvement of Pathology in Sub-Saharan Africa. The Lancet Oncology, 14, e152-e157. https://doi.org/10.1016/S1470-2045(12)70598-3
[60]
Wadler, B.M., et al. (2011) Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review. Journal of Oncology, 2011, H382-H387. https://doi.org/10.1155/2011/150423
[61]
Morhason-Bello, I.O., et al. (2013) Challenges and Opportunities in Cancer Control in Africa: A Perspective from the African Organisation for Research and Training in Cancer. The Lancet Oncology, 14, e142-e151. https://doi.org/10.1016/S1470-2045(12)70482-5
