Breast cancer in western part of Libya: Pattern and management (2003-2018)

Abstract

Background: Breast cancer is the second most common cancer in the world; the most frequent cancer among women, and leading cause of cancer death in females worldwide. Aim: The aim of the study is to study the pattern and treatment modalities for breast cancer patients who registered in Tripoli University Hospital from 2003 to 2018. Patients and Methods: A retrospective, cross-sectional study was conducted at the Oncology Department of Tripoli University Hospital. A convenience sample of 1000 breast cancer patients from 2003 to 2018 was chosen. Demographic, clinic-pathological characteristics, and treatment modalities data were analyzed by SPSS program version 20. Results: Of 1000 breast cancer patients, there were 984 (98.4%) females and 16 (1.6%) males, mean age was 46.1 ± 11.7 years old, most of them from western region. Majority (64.3%) of female were early age at menarche and 46.2% not breastfed. Positive family history of first degree was 28.8%. The left side presentation was the predominant (60.3%); half of the cases were in Stage II. Invasive ductal carcinoma was diagnosed among 62.5% of the cases and 47% of them were in Grade III. Positive estrogen receptor recorded in 73.8% of cases compared to 69.5% positive progesterone. Furthermore, 76.8% of patients had human epidermal growth factor receptor 2 negative and 78.4% of cases had high Ki-67 level. Regarding management, a combination of surgery, radiation, chemotherapy, and hormonal were provided to 58% of cases, 45.5% of patients who received chemotherapy were treated with FEC regimen. Hormonal therapy was given to 67.7% and tamoxifen is the most drugs used. Conclusions: The frequency is higher among younger age (<50 years), early age at menarche, breastfed less than a year, nearly half presented in late Stage (III, IV), invasive ductal carcinoma is predominant histopathological type, most cases were HER2 negative and high Ki-67 expression. More efforts toward primary prevention and early detection are recommended to reduce locally advanced breast cancer.