AN EVALUATION OF THE MANAGEMENT OF BREAST CANCER AT AHMADU BELLO UNIVERSITY TEACHING HOSPITAL SHIKA, ZARIA
AN EVALUATION OF THE MANAGEMENT OF BREAST CANCER AT AHMADU BELLO UNIVERSITY TEACHING HOSPITAL SHIKA, ZARIA
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Date
2011-06
Authors
BUSOLA, OLORUKOOBA AMINA
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Abstract
The incidence and mortality from breast cancer in Nigeria is on the increase. The health
care system in Nigeria is overburdened by the task of providing proper treatment and care
to breast cancer patients. Preventative strategies in the fight against breast cancer have not
been fully adopted. Anti-cancer drugs are not readily available and are expensive. This
retrospective study was designed to evaluate the therapeutic protocol used in the
management of breast cancer in a Nigerian Teaching Hospital, and also to investigate
factors influencing the management of breast cancer, with a view of improving the care of
patients with the disease. The clinical records of all cancer patients seen over a one year
period (January to December, 2008) were reviewed. The study sample consisted of all
breast cancer patients who had received therapy for a minimum of 6 months (total of 67
patients). Relative occurrence of breast cancer vis-à-vis other cancer types was 29%,
closely followed by cervical cancer (27%). Mean age of diagnosis was 47.82 years. There
were 66 females and 1male. Fifty-three of the 67 patients (79%) were married; and almost
unemployed. Prevalence by tribe, state of origin and geopolitical zone showed that breast
cancer was ubiquitous. Previous family history of breast cancer was reported in 24% of the
patients. About 68% of the patients had a previous lump and or cancer. Fifty-two per cent
of the female patients were premenopausal and 56% were multiparous (para 4 and above).
Thirty three percent used oral contraceptives. History of alcohol intake was recorded in
23% of the patients. Presence of a lump (93%) was the most common symptom and the
cancer was mostly in the right breast (50.7%). Invasive ductal carcinoma was the most
frequently diagnosed type of breast cancer (76%). Individual pharmacy records were not
available for all the patients. Majority of the patients were placed on
Cyclophosphamide/Adriamycin/Fluorouracil regimen (43%). Few patients received a
taxane-based regimen which is a more targeted therapy for breast cancer. Fifty per cent of
the patients had radiotherapy. Hormonal therapy used in 75% of the patient was tamoxifen.
Oncologists favored the use of newer hormonal drugs like anstrazole and exemestane.
There were lots of discrepancies on which healthcare professional was responsible for
providing services in a given information area. Surgeons and oncologists perceived
themselves as being responsible for providing services in most of the information areas
outlined. Roles of pharmacists in the management of breast cancer were not recognized by
other health care professionals. In conclusion, there is the urgent need for the therapeutic
protocol used in the management of breast cancer in the hospital be updated, standardized
and harmonized, especially between the surgeons and the oncologists. Though the hospital
protocol was in line with the Nigerian guidelines there is still need for the Nigerian
guidelines be kept up to date with the recent advances in breast cancer chemotherapy, as
outlined in the National Comprehensive Cancer Network clinical practice guidelines for
breast cancer so as to improve the quality of care offered to patients, thus improving their
relative survival rate.
Description
A THESIS SUBMITTED TO THE POSTGRADUATE SCHOOL, AHMADU BELLO
UNIVERSITY, ZARIA
NIGERIA
IN PARTIAL FULFILLMENT FOR THE AWARD OF MASTER OF SCIENCE IN
PHARMACOLOGY
DEPARTMENT OF PHARMACOLOGY AND THERAPEUTICS
AHMADU BELLO UNIVERSITY, ZARIA
NIGERIA
Keywords
EVALUATION,, MANAGEMENT,, BREAST CANCER,, AHMADU BELLO UNIVERSITY,, TEACHING HOSPITAL,, SHIKA, ZARIA