Pattern of patients presentation with metastatic breast cancer for palliative external beam radiotherapy in the University College Hospital Ibadan

Abstract

Background: Breast cancer is the most common cancer among Nigerian women. In Nigeria and indeed Africa as a continent, majority of patients present to the hospital with advanced diseases. This event is a major source of morbidity and mortality in our poor-resource setting and can significantly decrease patient's quality of life. Materials and Methods: Patient's case notes with advanced breast cancers referred for palliative radiotherapy were retrieved from the departmental archives. Patient's biodata was extracted, which included age, sex, and year of referral. Other information extracted includes histology types diagnosed at primary sites, presenting symptoms, type of imaging modality used for confirmation of metastasis, and sites of metastasis. Data collected were analyzed using SPSS version 20. Results: A total of 584 patients with advanced breast cancers were seen during the study period (January 2005 to December 2009), representing an annual referral rate of about 84 patients/year from various centers across the country. Four hundred and twenty-one patients were eligible for the study. The mean age of patients was 45.9 years with only two male patients. Bone was the most common site of metastasis (66.7%) followed by lungs (17.1%). Pain due to bone metastasis accounted for 62.7% of presenting symptoms, followed by dyspnea and cough from lung metastasis (17.1%), multiple symptoms (7.4%), and symptoms associated with brain metastasis (6.2%). Conventional X-ray remained the dominant imaging modality for the confirmation of metastasis in both bones and lungs which accounted for 69.8% of used imaging modalities. Conclusion: Breast cancer metastasis to the bone and lungs remain the major source of morbidity and mortality, with majority of patients presenting with pain and dyspnea. Conventional X-rays remain the common imaging modality for confirmation of metastases in our environment despite advanced imaging techniques (positron emission tomography (PET)–computed tomography and 18F-fluoro-2-deoxyglucose-PET) used for the similar purpose in other parts of the world.