Breast Cancer Management at a Tertiary Hospital in Tanzania: Implications for the Implementation of the New Cancer Guidelines

Authors

  • Larry O. Akoko Muhimbili University of Health and Allied Sciences
  • John M. Mtei Muhimbili Orthopedic Institute
  • Ally H. Mwanga Muhimbili University of Health and Allied Sciences
  • Obadiah V. Nyongole Muhimbili University of Health and Allied Sciences

DOI:

https://doi.org/10.4314/tmj.v31i3.388

Abstract

Background

Breast cancer is the second leading cancer among women in Tanzania accounting for about 3,000 cases and 1,300 deaths in 2018 alone. National Cancer treatment guidelines have been developed addressing management of patients with breast cancer. How current practice will need to change to conform to new guideline has not been investigated. Evidence is needed to understand how much changes will be needed to affect changes needed.

Objectives

This study sought to understand how breast cancer patients at Muhimbili National Hospital are investigated and assigned to treatment.

Methodology

A cross-sectional descriptive study was carried out among patients with breast cancer who underwent modified radical mastectomy at Muhimbili National Hospital in 2018. Consent was obtained and patient’s demography, clinical characteristics, investigations and treatment assignment was collected. Descriptive statistics were computed where proportions were used for categorical variables and means with standard deviations for age.

Results

A total of 80 patients with mean age of 49.9 (SD 13.5) years were involved. Fine Needle Aspiration Cytology was diagnostic in 19 (23.8%). Immunohistochemistry was not available before surgery and requested only in 60(70%). Regarding clinical status 65 (81.3%) of the patients were clinical stage III disease with only 58 (72.5) receiving neo-adjuvant therapy. None of the patients had mammography or CT scan done.

Conclusion

We have demonstrated that BC management at MNH is not concordant with any known international treatment guidelines. Furthermore, Multi Disciplinary Team approach is critically lacking and needs to be well defined if the new treatment guidelines were to be effective.

Recommendation

Improvement in Breast Cancer Management needs to embrace the concept of Multi Disciplinary Team approach.

Key words: Breast Cancer, Investigations, Traetment Guidelines.

Author Biographies

Larry O. Akoko, Muhimbili University of Health and Allied Sciences

Senior Lecturer, Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

John M. Mtei, Muhimbili Orthopedic Institute

General Surgeon, Neurosurgery Unit, Muhimbili Orthopedic Institute, Dar es Salaam, Tanzania

Ally H. Mwanga, Muhimbili University of Health and Allied Sciences

Lecturer, Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Obadiah V. Nyongole, Muhimbili University of Health and Allied Sciences

Senior Lecturer, Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

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Published

2020-10-07

How to Cite

Akoko, L., Mtei, J., Mwanga, A., & Nyongole, O. (2020). Breast Cancer Management at a Tertiary Hospital in Tanzania: Implications for the Implementation of the New Cancer Guidelines. Tanzania Medical Journal, 31(3), 32–44. https://doi.org/10.4314/tmj.v31i3.388

Issue

Section

Original Research