Browsing by Author "Zam, Farid S."

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    Carcinoma of the breast as seen at Muhimbili Medical Centre: a clinicopathological study of 100 female patients.
    (University of Dar es Salaam, 1996) Zam, Farid S.
    100 female breast cancer patients were the subject of this study, whose general objective was to findout and document the clinico-pathological pattern of presentation of carcinoma of the female breast in Tanzanian environment. Patients were seen by the author in both the outpatients surgical clinics and wards, where they were physically examined, underwent relevant investigations and treated accordingly. 50% of patients were below the age of 50 years, the median age being 44.9 years. There were no patients below the age of 20 years. Two peaks of age specific incidence rates were recorded. A lower peak in the fourth decade and a higher one in the sixth decade. 55% of the tumours were located in the left breast compared to 45% in the right breast. Nearly half (49%) of the tumours were found in the upper lateral (U.L) quadrant. Late stages of the disease (stages III and IV) were a common finding (93%). Only 8% of patients had a positive family history of breast cancer. Oral contraceptives use is not a predominant feature among breast cancer patients in Tanzanian environment. Only 15% of patients had used them. Invasive ductal carcinomas constituted 96% of the tumours. The remaining 4% were invasive tabular carcinomas. 24 of the 52 patients screened for estrogen receptors were positive, 28 were negative. Serum alkaline phosphatase levels were elevated in 33% of patients, while liver metastasis detectable by ultrasound were found in only 5% of patients. The study discusses the results including some of the causes contributing to late presentation such as delay by patients, and the health services, accessibility of medical services and psychological factors. The author recommends broader dissemination of knowledge about breast cancer in an attempt to reduce the number of late presentors. For early diagnosis, it is also recommended that histopatholgical services should be made available in the regional hospitals, while mammography in the consultant hospitals. Abdominal ultrasonography and radioisotope bone scanning are - recommmended for staging only for patients with elevated levels of serum alkaline phosphatase. Determination of estrogen receptors status of the tumours is recommended to predict tumour response hormonal manipulation.