Breast cancer in Kenya: a histopathologic and epidemiologic study

During 1981-1985, 417 cases of breast cancer were seen at the Department of Human Pathology, Kenyatta National Hospital, Nairobi, Kenya. During this period, 8041 cases of cancer were reported. Cancer of the breast accounted for 5% of all malignancies in Kenya and only second in number to cancer of the cervix. The incidence rate in females was 1.08 per 100,000 person-years. The incidence was low because the rural Kenyans have difficult access to the oncology facilities in Nairobi. The age specific incidence rates decreased after menopause. This is also found in other African countries but is in contrast with North America and Europe, where there is a rise after menopause. Young age of the first pregnancy, many pregnancies and a low fat content of the diet may contribute to the low incidence in post menopausal women. The distribution of the histological types was the same in Kenya with predominance of premenopausal cases and in the western world with predominance of postmenopausal cases. Invasive ductal carcinoma was the most common cancer type. Poorly differentiated tumours were common. This is probably explained by the fact that most patients seek medical help at a late state with advanced cancer. Only two cases of non-invasive intraductal carcinoma were found and in cases where lymphnodes were removed 88% had metastases.