Annals of African Surgery

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Metastatic Breast Cancer and Hormonal Receptor Status among a Group of Women in Sub Saharan Africa

A Nabawanuka, M Galukande, H Nalwoga, A Gakwaya


Background: Breast cancer is the third commonest cancer in women in Uganda. The majority of breast cancer patients in Uganda present with advanced disease. Many studies show that metastatic lesions frequently lodge in bones, lung and liver. Tumour hormone receptor status correlates with site of metastatic lesions and survival among breast cancer patients.
Objective: To determine the sites of metastatic breast lesions and how they relate to the hormonal receptor status.
Methods: In this cross sectional descriptive study, 71 women with histologically confirmed incident breast cancer with metastases were analysed, their hormonal receptor status was determined. All patients underwent a chest X-ray, an abdominopelvic ultrasound scan and a bone scan. The χ² and t tests were used to compare variables for statistical differences.
Results: The mean age of participants was 45 years. Most metastases were to bone 56% (40/71), of these 45% (32/71 ) tumours were exclusive to bone and 94% of these (30/32) were ER+ . Of the 13 (18% of all patients) who had metastases to the liver, 7 were exclusive to the liver, and 1 (14.%) was ER positive. Of the 30 (42 %) patients with lung metastases, 23 patients were exclusive to lungs and 9/30 (39%) were ER+. In all 68% (48/71) were ER+, and bone metastases were associated with ER positivity and low grade tumors.
Conclusion: Breast metastases had a preponderance to bone in this largely premenopausal group of women and these tumors were mostly ER positive. In the absence of tests to determine ER status, empirical antihormonal therapy may be used.

Key words: Metastatic Breast Cancer, Hormonal Receptor Status

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