Clinical, Prognostic and Socio-Economic Aspects of T4 Breast Cancers in Ouagadougou, Burkina Faso: A Retrospective Study

Abstract

Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival; obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.