Epidemiologic and Clinical Profiles of Breast Diseases in Niger

Affiliation

¹Department of Health Services Research & Administration , University of Nebraska Medical Center College of Public Health, Omaha, NE

²Niamey National Hospitals, Surgical Oncology Department, Niamey, Niger

³Department of Epidemiology, University of Nebraska Medical Center College of Public Health, Omaha, NE

Corresponding Author

Amr S. Soliman, M.D., Ph.D., Department of Epidemiology University of Nebraska Medical Center, College of Public Health 984395 Nebraska Medical Center Omaha, NE 68198-4395, Tel: 402-559-3976; Fax: 402-559-7259; E-mail: amr.soliman@unmc.edu

Abstract

This study aimed at characterizing epidemiologic and clinical profiles of breast diseases in Niger during 2010-2013 at the National Hospital of Niamey. Medical records were abstracted for demographic, reproductive, clinical, and treatment data. A process map of patient navigation and barriers to seeking medical care was developed after interviewing 26 local health professionals who encounter and/or manage breast diseases. We identified 245 breast cancers and 122 other breast diseases. Mean age of breasts was 45.4 (±13.26 years) and that of breast diseases was 31(±12.5 years) with 1/3 of cancers under age 44. Infection-related diseases represented 24% of non-cancers. Male breast diseases represented 4.75% of diseases and 2.05% of cancers. Only 37.1% of breast cancers had histopathologic confirmation and 90% of cancer patients presented at advanced stages and mastectomy was performed for 66% of breast cancers. Patient and system barriers to care were common in diagnosing and treating breast diseases. Women in Niger have double burden of infectious breast diseases and emerging breast cancer. Younger age and late diagnosis are common features. Reducing barriers to access to care, down-staging of cancer, implementation of clinical guidelines for managing advanced cases are important needs for reducing breast cancer morbidity and mortality in Niger.