Breast cancer and conservative surgery in sub Saharan Africa

This study investigated the profile of breast cancer patients in Tanzania during 1974-87 period. The results were compared with those of African patients in countries south of the Sahara. The maximum number of patients with breast cancer were seen in the sexually active age groups. In Sudan breast cancer was in leading position amongst all female cancers but with a lower proportion of women below 30 years, 6.4% (95% CI 5.3-7.6); x2 = 7.3 (p = 0.006). While in other sub-Saharan countries the disease ranked second to cervical cancer in frequency, but with a high proportion of patients below 30 years of age. This proportion was highest in Nigeria when compared with other African countries studied 14.7% (95% CI 8.9-22.3); x2 = 3.9 (p = 0.04). Mastectomy continues to be the treatment of choice for breast cancer in the sub Saharan countries despite the fact that this procedure is resented. Also that the Halstedian principle which governed the treatment of the disease for a century now has been disputed regarding its usefulness. The biological basis for adopting conservative surgery for breast cancer, the need for early detection and the oncogenesis of the disease are discussed.