Background: Third world breast cancer is characterized by late presentation, occurrence at relatively young ages and dismal mortality. This poor outcome has encouraged patients to patronize quacks and alternative healers. Public control measures have targeted mainly public education and provision of screening facilities. Recent reports from the developed world indicate a high association with obesity, tobacco and alcohol, habits which though not currently very popular in the third world are nevertheless increasingly accepted.

This study reports on the acceptance and adherence behaviors of patients presenting with a clinical suspicion of breast cancer at a breast clinic in Nigeria during a 5-year period (2004-2008). Of the 275 study patients, 28.7% (79 patients) refused a biopsy needed for a definitive diagnosis. Of those who agreed to a biopsy, 10.2% (28 patients) did not return for a follow-up visit. Mastectomy was offered to 140 patients, 47.9% (67 patients) refused the surgery. Of the 53 patients diagnosed with locally advanced lesions offered neo-adjuvant chemotherapy, 28.3% (15 patients) completed the recommended therapy. Of the 44 patients offered adjuvant chemotherapy, 38.6% (17 patients) completed the recommended therapy. Only 23 of the patients advised to go for radiotherapy complied. Barriers to patient adherence to diagnostic and treatment recommendations included both patient barriers and system barriers.

This study evaluated the potential risk factors for breast cancer in Nigerian women using a case-control design of 250 women with breast cancer and their age-matched female controls. Both cases and controls were recruited from 4 University Teaching Hospitals in Midwestern and Southeastern Nigeria. Data on the clinical and epidemiological characteristics were collected using intervieweradministered structured questionnaires. The mean age of the cases and controls were 46.1 and 47.1 years, respectively. Fifty-seven percent of the cases were premenopausal while 43% were postmenopausal. The association of risk factors with breast cancer was assessed using conditional logistic regression. Positive family history of breast cancer in first-and second-degree relatives (Odds ratio [OR] Breast cancer is currently the most common malignancy in Nigerian women and the incidence seems to be on the increase. 1 It has overtaken carcinoma of the cervix and if the present trend is maintained it will become, for Nigeria, and most other developing countries, the most important noncommunicable disease of the new millennium. It is a disease that carries in its wake huge socioeconomic, emotional and public health implications.The actual cause of breast cancer is unknown but studies have implicated age, sex, heredity, reproductive factors, diet and anthropometric characteristics as possible etiological factors. Most of the available literature on the role of these risk factors in breast cancer susceptibility is drawn from Caucasian populations. While these factors may be at play in Nigerian women, it is important to note that there is considerable variation in the geographical, racial and ethnic distribution of the disease due probably to environmental and genetic factors. 2 Anecdotal observations by clinicians in Nigeria suggest that the epidemiological characteristics of the disease in Nigerian women differ from that in Caucasian populations. For example, most women with breast cancer in Nigeria are multiparous and they practice prolonged lactation; factors that are thought to be protective against breast cancer.While several investigators have reported the clinical and pathological characteristics of breast cancer in Nigerian women, 3-6 little is known about risk factors of the disease in this population. 3,7,8 Yet it is the nature of the disease that each society, race and population must seek to define the characteristics of the disease among its people and evolve appropriate management strategy. This study sought to identify risk factors for breast cancer in Nigerian women. Identification of these factors may enhance the ability to prevent the disease by permitting better-focused health education and other preventive strategies. Material and methods Study populationThe study participants consisted of 250 breast cancer cases and 250 age-matched (within 5 years) controls recruited from 4 University Teaching Hospitals in Midwestern and Southeastern Nigeria, including the University of Benin Teaching Hospital, Benin City; Universit...

BackgroundLeptin, a 16 kDa polypeptide hormone, implicated in various physiological processes, exerts its action through the leptin receptor, a member of the class I cytokine receptor family. Both leptin and leptin receptor have recently been implicated in processes leading to breast cancer initiation and progression in animal models and humans. An A to G transition mutation in codon 223 in exon 6 of the leptin receptor gene, resulting in glutamine to arginine substitution (Gln223Arg), lies within the first of two putative leptin-binding regions and may be associated with impaired signaling capacity of the leptin receptor. This study was designed to assess the role of this polymorphism in breast cancer susceptibility in Nigerian women.MethodsWe utilized a polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) assay to evaluate the association between the Gln223Arg polymorphism of the leptin receptor gene and breast risk in Nigeria in a case control study involving 209 women with breast cancer and 209 controls without the disease. Study participants were recruited from surgical outpatient clinics and surgical wards of four University Teaching Hospitals located in Midwestern and southeastern Nigeria between September 2002 and April 2004.ResultsPremenopausal women carrying at least one LEPR 223Arg allele were at a modestly increased risk of breast cancer after adjusting for confounders (OR = 1.8, 95% confidence interval [CI] 1.0–3.2, p = 0.07). There was no association with postmenopausal breast cancer risk (OR = 0.9, 95% CI 0.4–1.8, p = 0.68).ConclusionOur results suggest that the LEPR Gln223Arg polymorphism in the extracellular domain of the LEPR receptor gene is associated with a modestly increased risk of premenopausal breast cancer in Nigerian women.

The goal of this study was to examine the adult surgical emergencies seen at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, with a view to proffering preventive solutions where appropriate and improving outcome. From the register of patients seen at the Casualty department and from the operations register in the main operation room of NAUTH, names and hospital numbers of adult patients treated as emergencies over a 5-year period, from 7 September 1998 to 6 September 2003, were obtained. The hospital folders were then retrieved from the Records Department. From each folder, the following details about each patient were extracted: age, sex, diagnosis at presentation, causative factors, treatment given, and outcome. A total of 902 adult patients were treated during the period. The commonest emergency operation was appendectomy for acute appendicitis in 139 patients (97 women and 42 men), followed closely by road traffic accidents (RTAs) involving 137 patients (103 men and 34 women). Gunshot injuries, which resulted mainly from armed robbery attacks, accounted for 127 cases. More men (113) sustained gunshot injuries than women (14). Of the 92 cases of acute intestinal obstruction seen, 62 occurred in women and 30 in men. Some 126 men presented with acute urinary retention, and two others presented with priapism. Governments at various levels should provide modern diagnostic tools for the accurate preoperative diagnosis of surgical emergencies in hospitals. Governments should also inculcate strict discipline into drivers using the highways, particularly in relation to abuse of alcohol and drugs. Good roads and adequate security should be provided for the people. The need for Pre-Hospital Care for the efficient evacuation of accident victims is emphasized. These measures will help to improve the management and outcome of surgical emergencies, and decrease the number of surgical emergencies resulting from RTAs and gunshot wounds.