Female breast cancer in sub-Saharan Africa: A PRISMA-S-compliant systematic review of surgery.

Autor: Amouzou KS; Department of Surgery, University of Lomé, Sylvanus Olympio Teaching Hospital, Lomé, Togo., Ketevi AA; Department of Gynaecology, University of Lomé, Sylvanus Olympio Teaching Hospital, Lomé, Togo., Sambiani DM; Department of Surgery, University of Lomé, Sylvanus Olympio Teaching Hospital, Lomé, Togo., Caroli A; Radiotherapy Unit, Centro di Riferimento Oncologico, IRCCS-National Cancer Institute, Aviano, Pordenone, Italy.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2022 Mar; Vol. 125 (3), pp. 336-351. Date of Electronic Publication: 2021 Nov 05.
DOI: 10.1002/jso.26720
Abstrakt: Background: In sub-Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgical interventions of female breast cancer (FBC) lead to poor outcomes. This study assessed current modalities of FBC surgeries.
Methods: Six literature databases (Medline, Embase, African Journal Online, Google Scholar, Web of Science, Cochrane Library) were searched, plus a manual search, in 2011-2021. We included primary data studies with any setting and presurgeries or postsurgeries treatments, we excluded non-English language studies, editorials, and grey literature.
Results: The search yielded 21 observational studies (16 retrospective, 3 prospective, and 2 case reports). Of the total 6900 patients, 4121 (60%) patients underwent FBC surgical excision only, and 751/2779 (27%) conservative surgery (BCS) or therapy (BCT). All studies reported similar use of mastectomy (>60%), the FBC surgical excision/reconstruction studies displayed more neoadjuvant chemotherapy (536/2779, 19% vs. 215/4121, 5%), and radiotherapy or adjuvant radiotherapy (1461/2779, 52% vs. 411/3921, 4%). Patients' age, histological classification, staging, and follow-up data were often missing.
Conclusions: The FBC complexity requires structured management by general and plastic surgeons, radiotherapy specialists, and obstetrician-gynecologists through shared guidelines, protocols, and specific programs of public health. In SSAs, FBC surgical strategies should point at decreasing radical mastectomy and increasing BCS/BCT.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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