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TNM classification and breast cancer in an African population: a descriptive study
H Amir1, M R Azizi, C K Makwaya
1Department of Surgery, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Objective:
To determine the stage of female breast cancer in an African population at presentation by using the TNM classification of the International Union Contra Cancer (UICC).
Design:
A descriptive study.
Setting:
Hospital based investigation.
Subjects:
All 50 female patients with breast carcinoma admitted between March and October 1996 to the surgery wards at the Muhimbili Medical Centre, the largest referral centre in Tanzania were studied for the stage of the disease at presentation.
Results:
A total of 50 cases were recruited in this study. There was not a single case in Stage I. In Stage II there was only one case (T2 N0, n = 1). There were seven cases in Stage IIIA (T3 N0, n = 5; T1 N2, n = 1; T3 N2, n = 1) while in Stage IIIB there were 37 cases (T3 N3, n = 1; T4 N1, n = 27; T4 N2, n = 9). There were five cases in Stage IV (M1, n = 5). Histological analysis revealed all tumours were infiltrating duct carcinoma. Metastatic disease (Stage IV) was observed only in patients aged above 50 years.
Conclusions:
Breast cancer presents predominantly as a locally advanced disease, with virtual absence of early disease. A majority of the patients are premenopausal in an African population. Self breast examination (SBE) including other strategies suggested earlier are recommended to aid in early detection of breast cancer.
