International Surgery Journal | September 2019 | Vol 6 | Issue 9 Page 3105 International Surgery Journal Umoke IC et al. Int Surg J. 2019 Sep;6(9):3105-3110 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Breast cancer in North-Central Nigeria: challenges to good management outcome Ifeanyi Charles Umoke 1 *, Ekundayo Stephen Garba 1,2 INTRODUCTION Breast cancer is the commonest malignancy affecting women in many parts of the world. Globally it accounts for 18.4% of female cancers. It is estimated that one in eight Caucasian women (one in 14 blacks) in the USA (double the risk in 1940) and one in 12 in Britain will develop breast cancer in their lifetime. The incidence in rising. 1 Currently the commonest malignancy in Ibadan Nigeria. In Accra, Ghana, it accounts for about 16.0% of all cancers being now the commonest cancer in the female. 1 Over 1 million new cases are diagnosed annually, resulting in over 400,000 annual deaths and about 4.4 million women living with the disease. 2 Breast cancer and its treatment constitute a great challenge in resource-limited societies. The hallmarks of the disease in Africa are patients presenting at advanced stage, lack of adequate mammography screening programmes, preponderance of younger pre-menopausal patients, poor access to adjuvant therapy and a high morbidity and mortality. 3-5 Chalya et al in North Western Tanzania noted a poor utilization of adjuvant chemotherapy by their patients resulting in non-completion of the prescribed courses and thus impacting negatively on outcome. 4 ABSTRACT Background: Breast cancer is a major health burden globally. Now ranked the number one cancer in females, and the leading cause of cancer deaths in females in our environment, outcome indices have remained poor in developing countries. The aim of this study was to ascertain the major challenges to good management outcome of breast cancer patients in our centre. Methods: The case notes of all histologically confirmed cases of breast cancer presenting to our centre from January 2016 to December 2017 were reviewed. Information on the variables of interest were extracted using a proforma. Results: Fifty-five (55) patients’ case notes were reviewed. All were females. 30.9% of the patients had early disease versus 67.3% with advanced disease. 76.4% had invasive ductal carcinoma. More lesions occurred on the left and the upper outer quadrants. 46% of the 37 patients with advanced disease who required chemotherapy completed the prescribed six courses. None of the patients who required radiotherapy received it. Only 1.8% of those who required hormonal therapy were still taking them at two years follow-up. 3.6%, 11%, and 0% used alcohol, oral contraceptives and tobacco respectively. 81.8% had been lost to follow-up at two years while 14.5% had died while on admission. Conclusions: This study identified late presentation with advanced disease; poor compliance and adherence to treatment strategies, and poor access to adjuvant therapy as the major challenges to good outcome for this disease. Keywords: Breast cancer, Challenges, Management outcome Department of Surgery, 1 University of Abuja Teaching Hospital, 2 College of Health Sciences University of Abuja, Gwagwalada, Abuja, Nigeria Received: 05 June 2019 Revised: 19 July 2019 Accepted: 26 July 2019 *Correspondence: Dr. Ifeanyi Charles Umoke, E-mail: ifeanyiumoke@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20194042