A decade of strengthening breast oncology in Ethiopia

Taylor, Lesley; Harris, Carol E.; Abebe, Tamrat; Addissie, Adamu; Assefa, Mathewos; Kantelhardt, Eva Johanna

doi:10.1016/s1470-2045(21)00254-0

Cited by 8 publications

(9 citation statements)

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“…Understanding the true distribution of breast cancer phenotypes among populations would help with allocation of resources associated with treatment (chemotherapy, endocrine therapy) and anticipated costs, human resources, and equipment. In settings with limited resources, prioritization of which reagents to purchase to perform IHC must account for the clinically useful and actionable information it will provide the clinician in making treatment decisions [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Building Pathology Capacity in Sub-Saharan Africa to Improve Breast Cancer Diagnosis and Treatment: Training Laboratory Technicians in High-quality Manual Immunohistochemistry

Setiawan,

Graef,

Schmolze

et al. 2023

Preprint

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Background: To address the need for a skilled workforce in breast cancer (BC) pathology in sub-Saharan Africa (SSA), we implemented an education program to train laboratory technicians in manual immunohistochemistry (IHC). Methods:A cross-sectional quality improvement education project was developed. Interactive webinars were held every six months with didactics and presentations from African experts with experience in IHC. We conducted knowledge assessments and surveys on current practice, equipment, and human resources. A digital mentorship platform (DMP) was created for discussions, sharing SOPs, and networking. For one year (2022-2023), we followed developments in pathology capacity, practice changes, and educational needs. Results: 266 participants from 10 SSA countries attended the first webinar, a series of six lectures on IHC theory, methods, and practice. 95 participants from nine SSA countries provided a baseline assessment of pathology capacity and feedback. Mean knowledge increased by 17.4% (from 41.8% pre-webinar to 59.2% post, p=<0.0001). Self-reported confidence in topics increased by 11.3% (mean 3.36 pre- to 3.74 post, p=0.1). Over six months, recordings were accessed 412 times. After six months, the second webinar had 93 participants from eight SSA countries. Membership in the DMP increased from 64 to 172; recordings were viewed 412 times in six months; and 113 participants from nine SSA countries completed surveys. Among 74 respondents who perform IHC, 43.5% reported moderate or significant positive practice changes such as improved antigen retrieval techniques and optimization of preanalytical variables. The majority (52.7%, n=39) reported the quality of slides had moderately or significantly improved. After one year, a third webinar had 98 participants from eight SSA countries. Thirty-eight completed surveys, DMP membership increased to 199, and 1 reported launching IHC in a lab in Nigeria. Conclusions: Our program 1) reached hundreds of participants and provided a baseline assessment of pathology capacity across nine SSA countries; 2) created a novel mechanism to build pathology capacity and assess progress with this cohort; and 3) improved practices and the preparation of slides for the majority performing manual IHC. After one year, interest was sustained. Tracking impact on diagnosis and treatment of BC in the region is needed long-term.

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Section: Discussionmentioning

confidence: 99%

Building Pathology Capacity in Sub-Saharan Africa to Improve Breast Cancer Diagnosis and Treatment: Training Laboratory Technicians in High-quality Manual Immunohistochemistry

Setiawan,

Graef,

Schmolze

et al. 2023

Preprint

Self Cite

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“…There are significant human and material resource limitations in the management of BC which could contribute to poor oncologic outcomes. 3,9 Breast cancer is the most common cancer occurring in 1 in 3000-10,000 pregnancies. 2 The prevalence and management of PABC is unknown in Ethiopia.…”

Section: Discussionmentioning

confidence: 99%

“…This case highlights the challenging clinical situation that the patient, fetus and treating physicians have to face both in the diagnosis and management and the need for the establishment of improved Maternal-Fetal Medicine (MFM), oncologic setup and treatment guidelines and, moreover, international collaborative efforts to reduce disparity and close the gap in cancer care. 3 The patient in this case presents a rare type of apocrine carcinoma histology occurring in PABC. The clinical relevance of this pathology in PABC is yet unknown, therefore, further studies are needed.…”

Section: Introductionmentioning

confidence: 87%

Pregnancy Associated Invasive Apocrine Carcinoma of the Breast: Case Report from Ethiopia

Alemu¹,

Hammad²,

Tola³

et al. 2023

BCTT

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We present a case report on a case of invasive apocrine carcinoma of breast during pregnancy at a tertiary referral hospital in Ethiopia. The patient's case in this report signifies the challenging clinical situation that the patient, developing fetus and treating physicians have to go through and the need to improve maternal-fetal medicine and oncologic setup and treatment guidelines in Ethiopia. Our case also illustrates the huge disparity between the management of both breast cancer and its occurrence during pregnancy in low-income countries like Ethiopia and developed nations elsewhere. Our case report shows a rare histological finding. The patient has invasive apocrine carcinoma of the breast. To our knowledge, it is the first case to be reported in the country.

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“…It will tackle the condition with a holistic approach, integrating different specialities. The collaborative work done by the Ethiopian Cancer Group is a good example [ 36 ]. Sudan can also benefit from South-South collaboration and knowledge transfer in emulating the successful adoption of HPV vaccination, similar to Senegal, a predominantly Muslim sub-Saharan country, which introduced it in 2018 in partnership with Gavi [ 14 ].…”

Section: The Current Situationmentioning

confidence: 99%

Women’s cancers in Sudan with a focus on cervical cancer: turmoil, geopolitics and opportunities

Husain¹,

Burhan²,

Ahmed³

et al. 2022

ecancer

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Cancer is the leading cause of death worldwide and the second leading cause of death in Sudanese women. However, despite proven interventions for primary, secondary and tertiary prevention and the World Health Organization's call to action toward eliminating cervical cancer, there has been little progress in addressing the cervical cancer burden in Sudan. This short communication intends to shed light on the challenges facing women's cancers in Sudan, taking cervical cancer as an example. It also discusses the opportunities and suggests ways to improve the outcomes of women's cancers in Sudan. Sudan's government should urgently implement a broad public health strategy to improve outcomes for women with cancer. The cancer control plan should be aligned with international, evidence-based recommendations and adapted to local circumstances. It should strengthen health literacy, augment different health care interventions, including vaccination, committed screening programmes, early detection and proper diagnosis of symptomatic cases, a programmatic approach to active management and palliative care and ensure robust referral pathways. Policies are also needed in collaboration with the international community in addressing the cancer care needs of internally displaced and refugee women in Sudan. The strategy should consider overcoming the existing challenges and making the most opportunities available.

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A decade of strengthening breast oncology in Ethiopia

Cited by 8 publications

References 0 publications

Building Pathology Capacity in Sub-Saharan Africa to Improve Breast Cancer Diagnosis and Treatment: Training Laboratory Technicians in High-quality Manual Immunohistochemistry

Building Pathology Capacity in Sub-Saharan Africa to Improve Breast Cancer Diagnosis and Treatment: Training Laboratory Technicians in High-quality Manual Immunohistochemistry

Pregnancy Associated Invasive Apocrine Carcinoma of the Breast: Case Report from Ethiopia

Women’s cancers in Sudan with a focus on cervical cancer: turmoil, geopolitics and opportunities

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