Breast cancer and prevention perspectives: A public health challenge, Buea regional hospital, Cameroon

Abstract

With 2.100.000 cases annually, breast cancer (BC) is the most common gynecological cancer globally; 627.000 of those cases result in death yearly. In the next 20 years, it is anticipated that there will be 14.000.000 cases annually and 8.200.000 fatalities. There are numerous histological subtypes of BC. The various cancers include invasive ductal carcinoma, papilloma, medullary carcinoma, phyllode tumors, ductal carcinoma in situ, lobular carcinoma in situ, and Paget disease. BC is a huge public health concern because of the steadily rising cases in our low-resource environments, thus raising the stakes to develop effective screening and early detection programs to reduce morbidity and mortality. Breast ultrasonography and clinical examination appear to hold promise for screening campaigns. Methodology: On the one hand, a descriptive retrospective analysis was conducted based on the pathology laboratory registry of the regional hospital in Buea, Cameroon. The time frame was from March 4, 2016, through May 25, 2019. On the other hand, we appreciate the rising number of women who attended BC screening programs from 2020 to 2022. BC was screened via clinical breast examination and breast ultrasonography before biopsy for confirmation. Results: In terms of frequency, the following precancerous lesions and cancers were recorded: invasive breast carcinoma, carcinoma in situ, papilloma, inflammatory carcinoma, phyllode tumours, and angiosarcoma. Their respective percentages were; 74.84, 14, 47, 6.92, 1.89, 1.57, and 0.32. The number of women who came for BC screening increased steadily from 123 in 2020 to 266 in 2021 and 552 in 2022. All with positive biopsy results first underwent a clinical examination. In the presence of any suspicious signs, an ultrasound investigation was ordered. A biopsy was requested in case of any image suspicious of BC. Response to the cancer screening campaigns in Buea has increased markedly since the project's initiation. Conclusion: Breast cancer is a heterogeneous malignancy made of various histological types. Our study identified the following pathologies in order of frequency: invasive breast carcinoma, ductal carcinoma in situ, papilloma, inflammatory carcinoma, phyllode tumours, and angiosarcoma. As awareness grows as years go by, there is a huge public health challenge. For mass screening, Clinical examination of the breasts and breast ultrasound seems to be the way forward in prevention, as recommended by many clinical trials and WHO. Objectives: The study aimed to determine the frequency of various types of breast cancer and find a good grassroots approach to BC screening in low-resource settings like ours.