Breast Cancer Treatment in Nigeria: Cost of Mastectomy in Nigeria, How much does breast lump removal surgery cost in Nigeria?, cost of breast removal surgery in Nigeria.
Cancer of the breast is the most common malignancy affecting women in many parts of the world. Globally it accounts for 18.4% of female cancers. It is estimated that one in 8 Caucasian women (one in 14 blacks) in the USA (double the risk in 1940) and one in 12 in Britain will develop cancer of the breast in their lifetime and the incidence is rising.
In the USA, the incidence since 1982 has been rising by 4.5% per year. In 2002 there were 1,151,298 new cases worldwide, 514,072 of them in developing countries, 410,712 deaths and
more than 4.4 million women living with the disease. Of the developed countries, Japan has the lowest incidence – one in 60 women in their lifetime – and the death-rate is about 30% of that in Britain. But as in other developed countries it is rising rapidly.
In Nigeria, it is currently the commonest malignancy an the number one killer of women. In Accra, Ghana, it accounts for about 16.0% of all cancers, being now the commonest cancer in the female.
Although the incidence is rising in the West, the mortality has been reducing since the 1990′ s due to early detection of the disease and improved adjuvant therapy .
Symptoms and Signs
It is rare under 20 and only a few patients are between 20 and 30. The incidence then rises steadily to 40 and increases only slightly to 50. There is then a progressive rise again to 80.
Most breast cancer patients are, however, between 45 and 65 perhaps because ofthe hormonal imbalance during the menopause;in developed communities a third of patients are over 70.
Currently in Nigeria, it appears from the current relative age specific rates that the incidence peaks in the 36-45 age group and then falls only to rise again from 65 upwards.
Carcinoma of tbe breast may present as:
1. Painless swelling ill the breast most commonly (The upper outer quadrant is the commonest site). In some, especially thoscwith inflammatory carcinoma, the swelling may be painful.
2 Mammographic (or screen-detected) abnomwlity.
With screening mammography, duct carcinoma-in-situ and minimal invasive cancer can be detected before a mass becomes palpable.
3. Blood-stained nipple discharge.
4. Retraction of the nipple.
5. Lymphoedema/swelling of the breast and/or arm.
6. Eczema or dermatitis of the areola.
7. Dimpling of the breast
7. Metastasis (spread to the lungs, bones, liver, brain, and skin
(i) Pulmonary(lung) symptoms of cough or difficulty in breathing from deposits in the lung and/or pleura.
(ii) Osseous deposits may cause bone pain especially backache, pathological fractures especially of the femur, bony swelling, e.g. of the skull, ribs.
(iii) Paraplegia from cord compression due to vertebral deposits or fracture.
(v) Hepatomegaly (enlarged liver), jaundice and ascitis from liver metastases.
(vi) Cerebral metastases may present with headaches, vomiting, altered consciousness or coma
Differential Diagnosis…A lump in the breast does not always equate to breast cancer.. It may be as a result of other breast diseases listed below 👇
2 Benign mammary dysplasia (fibroadenosis)
5. Traumatic fat necrosis
6. Chronic breast abscess
7. Duct ectasia
8. Burkitt’s lymphoma
TREATMENT OF BREAST CANCER
The principal treatment modalities are:
1. Loco-regional therapy
2. Systemic therapy
i. Cytotoxic chemotherapy and
ii. Hormonal therapy.
3. Tumour cell specific therapy
The optimum management of breast cancer, especially of “curable” cancer, is still controversial although certain guiding principles of treatment are becoming apparent as a result of information from randomized clinical trials and meta-analysis of many of the results. Consequently, there is at
present some consensus on treatment modalities. But there are still many unanswered questions about the disease.
SURGERY – BREAST REMOVAL AND LUMP REMOVAL SURGERY
Breast removal surgery is the mainstay of treatment malignant breast cancers in Nigeria and also globally..
The surgical treatment of breast cancer aims to:
l. to determine the tumour type and its extent.
2 to eradicate local or regional breast cancer and so improve survival.
3. to prevent local recurrence.
4. to minimize distant spread (metastatic cells).
The current operative procedures are:
1. Wide local excision (lumpectomy,quadrantectomy, segmental mastectomy) with or without axillary lymph node
clearance followed by radiotherapy (Breast Conservation Therapy [BCT] or Surgery [BCS]). A large part of the breathing remains and only the tumour is removed..
2. Total mastectomy with or without axillary lymph node clearance depending on sentinel mapping. Here the whole diseased breast is removed especially if it is cancer.
Cost of Mastectomy in Nigeria/How much does breast lump removal surgery cost in Nigeria?
Compared to chemotherapy and radiotherapy or hormonal therapy for breast cancer, mastectomy (breast removal surgery) is less expensive. The cost of mastectomy in Nigeria is around N600,000 to 750,000 Naira excluding fees for elaborate investigations. The stated amount include surgery fees, blood, anaesthesia fees, drugs, consumables dressings, bed stay and so on. Mastectomy can be done in many part of Nigeria including, Lagos, Abuja, Benin, Port Harcourt, Kano, Kaduna.
For a non-cancerous breast lump, lumpectomy (breast lump removal) in Nigeria cost around N60,000 to N100,000 naira. Please note that an an excised breast lump must be sent to the lab for histology to be sure it is not cancer.
PRINCIPLES AND PRACTICE OF SURGERY (BADOE)