Breast Cancer: Epidemiological, Clinical, and Therapeutic Aspects in Pointe Noire (Congo Brazzaville)

Introduction: Breast cancer is the leading cancer and the leading cause of cancer death in women worldwide. The objective of our study was to describe the epidemiological, clinical and therapeutic aspects of breast cancer at the General Hospital of Loandjili in Pointe Noire. Patients and Methods: This was a descriptive and cross-sectional study that took place in the Cancer Department of the General Hospital of Loandjili in Pointe Noire during the period from January 1st, 2012 to December 31st, 2016 for duration of 5 years. 54 records of patients over 18 years of age with histological evidence were collected. The variables studied were: age, level of education, time to presentation, telltale sign, stage of extension, histological type, and histological grade. Chi-square test was used to compare variables and groups. Results: At the end of this study, we collected 54 files of breast cancer patients from 150 patients hospitalized in the Cancer Department. The frequency of breast cancer was 36%. The average age was 50 ± 13.6 years;the extremes were 27 years and 79 years. The most represented age group was from 37 to 40 years old with a percentage of 28%. The patient’s level of study was primary in the majority of cases (57%). The most represented histological type was invasive ductal carcinoma, (100%). The majority of patients arrived at advanced stages 44.4% and metastatic stages 26%. Patients were treated in most of cases by chemotherapy (82%), surgery (42%) and radiotherapy (10%). There was a correlation between time of presentation and stage of extension. Conclusion: Breast cancer is the first cancer of the woman in Pointe Noire. Patients arrive at advanced stages;the most common histological type is invasive ductal carcinoma. The presentation time is correlated with the extension stage. These results suggest the establishment of a cancer control program in developing countries.

Hematological Toxicity during Breast Cancer Chemotherapy in Pointe-Noire (Congo Brazzaville)

Introduction: The objective of our study was to determine the prevalence of hematological toxicity during breast cancer chemotherapy. Patients and Methods: This was a cross-sectional descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2021 to December 31, 2021, i.e. a period of 1 year. Were included in our study: patients with and histological diagnosis, and having received at least two cycles of chemotherapy and having presented hematological toxicity: anemia and/or neutropenia. The variables studied were: Age, level of study, socioeconomic level, stage of extension, type of chemotherapy, type of toxicity: neutropenia and anemia. Bivariate analysis was done between anemia, neutropenia and type of chemotherapy. Results: The average age of the patients was 50.35 ± 13.6 years. The extremes were 27 years and 79 years old. The most represented age group was the age group from 37 to 46 years with 18 cases or 33.33%. The most represented level study in our study was the primary level 63%, followed by secondary level 26% and the upper or superior level 11%. Metastatic stage of location was represented in 16.6% of cases, the local stage was represented in 16.7% of cases. The most common chemotherapy used was FAC protocol in 50% of cases, followed by FAC + DOCETAXEL in 47% of cases, AC protocol was used in 3% of cases. The most represented grade of neutropenia was grade 3 in 53% of cases, followed by grade 2 in 27% of cases and grade 1 in 20%. Grade 1 anemia was the most represented in 70% of cases, followed respectively by grade 2 in 27%. The majority of patients had received more than 3 courses of chemotherapy in 83% of cases. Grade 3 neutropenia was observed mostly in the advanced stages, 15 cases at the locoregional stage. Grade 1 anemia was most common in patients who received more than 3 courses of chemotherapy. The FAC chemotherapy protocol was responsible for more grade 3 anemia in 14 cases. FAC-type chemotherapy was associated with grade 3 and 2 neutropenia in 8 cases and 4 cases, but the results were not significant. FAC + DOCEAXEL type chemotherapy was also responsible for grade 3 and 2 neutropenia in 8 cases and 4 cases P > 5% respectively. Conclusion: Hematological toxicity in the context of our limited resources is dominated by anemia and neutropenia. The knowledge of this hematological toxicity is necessary for the limitation of the delay of chemotherapy.

Epidemiological Clinical and Histological Aspects of Gynecological and Breast Cancer in Pointe Noire (Congo Brazzaville)

INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2012 to December 31, 2021, i.e. a period of 10 years. Women with histological diagnosis of gynecological and breast cancers were included in our study. The variables studied were: frequency, age, alcohol and tobacco consumption, histological type, stage of extension, location of cancer. Bivariate analysis was done between age and location of the tumour. The statistical test used was the KHI2 test. The results were statistically significant for a value of p RESULTS: We collected 400 files from women with cancer. Among the 400 files, 265 were represented by gynecological and breast cancers, that is a frequency of 65.43%. Among the 265 cases of gynecological and breast cancer identified during this study period, breast cancer represented the first rank with 52% frequency. Cervical cancer accounted for 41% followed by ovarian cancer (5%) and endometrial (2%). Cancer of vulva was represented by a single case. The average age of patients with gynecological and breast cancers during our study was 52 ± 12 years. The average age of patients with cancer of the breast, cervix, ovarian, endometrial was respectively 49 ± 11.97 years, 54.73 ± 12.91 years old, 50 ± 14 years, 67 ± 14.24 years, the age of the vulva cancer patient was 51 years old. The histological type of breast cancer was represented by infiltrating ductal adenocarcinoma in 91% of cases, invasive lobular carcinoma in 7% and sarcoma in 2%. Cervical cancers were represented by squamous cell carcinomas in 95% of cases and adenocarcinomas in 5% of cases. Vulva cancer was represented by squamous cell carcinoma, ovarian cancer was represented by epithelial tumors (adenocarcinoma) in 100% of cases. Endometrial cancers were represented by endometrial adenocarcinoma. All cancers were diagnosed at advanced stages (locoregional and metastatic stage). Patients over the age of 50 had more gynecological and breast cancers;but this result was not significant. CONCLUSION: Gynecological and breast cancers are frequent and constitute the first cancer of Congolese women in Pointe-Noire. Breast cancer is the first cancer followed by cancer of the cervix and ovaries. The histological types are those of the literature. Patients with gynecological and breast cancers consult at very advanced stages.

Metastatic Breast Cancer Survival in Pointe Noire: Analysis of 30 Cases

Introduction: Breast cancer is the leading cancer and the leading cause of cancer death in women worldwide. About 5% to 10% of breast cancer patients present with metastases. While the 5-year survival of patients with local breast cancer varies around 98.8%, this survival rate drops to around 26.3% for metastatic patients. The objective of this study was to determine the survival of patients with metastatic breast cancer in resource-limited settings. Patients and Methods: This was a cross-sectional descriptive study that took place in the Cancer Department of the General Hospital of Loandjili in Pointe Noire during the period from January 1, 2013 to December 31, 2018, for duration of 6 years. 30 records of patients over 18 years of age and with histological evidence who received at least 3 courses of chemotherapy were collected. The variables studied were: age, level of education, socio-economic level, menopausal status, history, WHO status, menopausal status, tumor size, histological type, tumor location, the type of treatment and survival. Survival was calculated by Kaplan Meier method. Fisher’s exact test was used to search for correlation between variables. Results: The average age was 52.62 ± 10.96 years old. The extremes were 33 years and 75 years old. The most represented level of education was the primary level in 67% of cases. The majority of patients had low socioeconomic status in 50% of cases. The patients were menopausal in 57% of cases. The antecedents of cancer were present in 13% of cases. 50% of patients had a WHO status performance at 2. The tumor size was greater than 2 cm in 77% of cases. The most represented histological type was invasive ductal carcinoma in 93% of cases. The most represented histological grade was Scharff grade III Richardson bloom in 80% of cases. The most represented metastatic localization was pulmonary in 33% of cases. The metastatic localizations were unique in 47% of cases and multiple in 53% of cases. Anthracycline-based chemotherapy was more used in 53% of cases. Bivariate analysis revealed a correlation between tumor size and number of metastases, p 0.05. Patients treated with anthracyclines were greater than that of patients treated with taxanes in combination was 26.48 months, p > 0.05. Conclusion: Metastatic breast cancer remains an incurable disease, its survival remains low despite diagnostic and therapeutic advances that remain difficult to access for our resource-poor developing countries. Patients are treated with conventional chemotherapy (anthracyclines and taxanes). The most common metastases are respectively pulmonary, hepatic and cerebral in our context.

Prostate Tumors Diagnosis: Place of Fine Needle Aspiration in Congolese Patients

Objective: To determine the kappa (κ) concordance coefficient between fine needle aspiration and serum prostatic antigen (PSA) coupled with digital rectal examination and prostatic ultrasound. Material and Methods: We conducted a cross-sectional study covering the period from January 1st to June 30th, 2018 in the city of Pointe-Noire. It is a study of 31 cases of prostate tumors in Congolese subjects at the General Hospital of Loandjili in Pointe-Noire of Congo Brazzaville. The clinical, biological, ultrasound and cytological aspects were the variables of the study. Results: The mean age was 71.06 years with extremes of 57 and 93 years. One patient had a family history of prostate cancer that was found at his brother’s house at the age of 52. Dysuria was the most represented sign in all of our patients. Suspicion of prostate cancer was the most commonly talked in digital rectal examination. Prostate specific antigen (PSA) was greater than or equal to 10 ng/ml in more 74% of our patients. 61.3% of our patients had a heterogeneous prostatic ultrasound. 48.3% of malignant tumors and 32.3% of benign tumors were found cytologically. The association between digital rectal examination and prostatic ultrasound was statistically significant (p ≤ 0.05) and good agreement was found between cytological diagnosis coupled with digital rectal examination and prostatic echostructure (0.6 ≤ κ ≤ 0.8). A low concordance between prostatic specific antigen (PSA) and cytological concordance was noted (0.2 ≤ κ ≤ 0.4). Conclusion: Prostatic tumors in Congo in their diagnostic particularities are dominated by malignant tumors with a large number of patients to watch. The fine needle aspiration is suitable for orientation examinations of prostatic tumors and can be performed by any doctor and provides us a fast, effective diagnostic orientation with a strong clinico-morphological correlation in our low incomes countries.