Breast Cancer in Makurdi, North Central Nigeria: A 10-Year Histopathological Retrospective Survey
Keywords:
Breast Cancer Epidemiology, Histopathological Patterns, Invasive Ductal Carcinoma, Malignant Breast LesionsAbstract
Breast cancer remains the most common malignancy among women globally and is increasingly recognised as a major public health issue in Sub-Saharan Africa, including Nigeria. Understanding the histopathological patterns of malignant breast lesions is essential for effective diagnosis, management, and policy development. This study was set to determine the histopathological spectrum and demographic distribution of malignant breast lesions in a Nigerian cohort and to compare the findings with similar studies in Nigeria, Sub-Saharan Africa, and globally. It was a retrospective descriptive analysis and was conducted on 147 (100%) histologically diagnosed malignant breast lesions. Data collected included patient sex, age, and type of malignant lesion. Descriptive statistics, Tables, Bar charts, and Pie charts were used to illustrate the distribution of lesions. Females accounted for 96.6% (142) of cases, males represented a minor fraction of 3.4% (5), giving a male-to-female ratio of 1:30. The mean age for the disease was 55.2 years. Invasive ductal carcinoma (IDC) was the predominant subtype, of 71.2% (104) of all the malignant breast cases. Soft tissue malignant lesions 7.5% (11), lobular carcinoma 5.5% (8) Mucinoid carcinoma 4.1% (6), metastatic carcinoma in 0.7% (1) and rare tumours such as alveolar rhabdomyosarcoma were 0.7% (1) of the cases. The findings reaffirm the dominance of invasive ductal carcinoma among malignant breast lesions, with a relatively younger mean age of presentation compared to Western populations. These patterns emphasise the need for strengthened early detection programs and highlight regional variations that must be considered in public health planning and resource allocation.
References
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
2. Jedy-Agba E, McCormack V, Adebamowo C, dos-Santos-Silva I. Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health. 2016;4(12): e923–35.
3. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, eds. WHO Classification of Tumours of the Breast. 5th ed. Lyon: IARC Press; 2019. 4. DeSantis CE, Ma J, Gaudet MM, Newman LA, Miller KD, Goding Sauer A, et al. Breast cancer statistics, 2019. CA Cancer J Clin. 2019;69(6):438–51.
4. Fregene A, Newman LA. Breast cancer in sub-Saharan Africa: how does it relate to breast cancer in African-American women? Cancer. 2018;103(8):1540–50.
5. Adesunkanmi AR, Lawal OO, Adelusola KA, Durosimi MA. Breast cancer in Nigeria: a ten-year review of clinical and pathological correlates of survival. West Afr J Med. 2018;37(3):157–63.
6. Ibrahim IM, Mohammed A, Atanda AT, Oluwasola AO, Adeoye AO. Histopathological profile of breast cancer in a tertiary hospital in Nigeria: a 10-year retrospective review. Niger J Clin Pract. 2020;23(3):305–11.
7. Anyanwu SN, Egwuonwu OA, Ihekwoaba EC. Male breast cancer in Nigeria: a 12-year review of clinical and pathological correlates. West Afr J Med. 2017;34(1):36–42.
8. Olu-Eddo AN, Ugiagbe EE. Invasive breast cancer in Nigerian women: analysis of clinicopathological and molecular characteristics. Niger J Surg. 2020;26(2):101–5.
9. Sengal AT, Gabriel EE, Dahmoune C, McCormack V. Receptor-defined breast cancer subtypes in African women: a systematic review. Cancer Epidemiol Biomarkers Prev. 2017;26(6):899–908.
10. Lawal OO, Atoyebi OA, Adesunkanmi ARK. Trends in breast cancer histopathology in a Nigerian tertiary hospital. Niger Postgrad Med J. 2022;29(2):102–10.
11. Brinton LA, Figueroa JD, Awuah B, Yarney J, Wiafe S, Wood C, et al. Breast cancer in Sub-Saharan Africa: opportunities for prevention. Breast Cancer Res. 2020;22(1):17.
12. Kantelhardt EJ, Mathewos A, Aynalem A, Wondemagegnehu T, Trocchi P, Addissie A, et al. Breast cancer in Ethiopia: evidence for geographic difference in the distribution of molecular subtypes. Breast Care. 2022;17(2):123–8.
13. Adebamowo CA, Famooto A, Ogundiran TO, Aniagwu T, Nkwodimmah C, Akang EE. Molecular subtypes of breast cancer in Nigerian women. Cancer Epidemiol. 2021; 74:101980.
14. Gukas ID, Jennings BA, Mandong BM, Igun GO, Girling AC, Manasseh AN. Clinicopathological features of breast cancer in Jos, Nigeria. West Afr J Med. 2019;38(3):218–23.
15. Anderson WF, Jatoi I, Tse J, Rosenberg PS. Male breast cancer: a population-based comparison with female breast cancer. J Clin Oncol. 2018;124(5):1061–9.
16. Rakha EA, Ellis IO. Breast cancer histopathology reporting: updates and controversies. Semin Diagn Pathol. 2018;35(5):336–44.
17. Horne HN, Oh H, Sherman ME, Palakal M, Hewitt SM, Schmidt MK, et al. Etiologic heterogeneity for breast carcinoma subtypes defined by immunohistochemical markers. Cancer Epidemiol Biomarkers Prev. 2020;29(7):1369–78.
18. Gueye SMK, Diallo I, Touré BA, Diop PS, Moreau JC. Breast cancer in Senegal: clinical, therapeutic and evolutive aspects. J Afr Cancer. 2021;13(2):113–20.
19. Abudu EK, Banjo AA, Izegbu MC, Anunobi CC. Histopathological patterns of breast cancer in Lagos, Nigeria. Ann Afr Med. 2019;18(2):81–5.
20. Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, et al. Breast cancer—major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(4):290–303.
21. Mohammed AZ, Edino ST, Ochicha O, Alhassan SU. Breast cancer in Northern Nigeria: a changing paradigm. Niger J Med. 2020;29(1):74–8.
22. Ntekim A, Nufu FT, Campbell OB. Trends in breast cancer characteristics in Ibadan, Nigeria. Afr Health Sci. 2019;19(4):242–6.
23. Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer. World J Surg Oncol. 2018;16(1):68.
24. Bray F, Laversanne M, Weiderpass E, Soerjomataram I. The ever-increasing importance of cancer as a leading cause of premature death worldwide. J Cancer Policy. 2021; 27:100263.
25. Otubu JA, Okeke EN, Ezenwosu NE. Histopathological pattern of breast malignancies in Jos, North Central Nigeria: A 10-year review. Niger J Med. 2018;27(4):421–426.
26. Ntekim A, Nwana E, Oyesile O. Pattern of presentation and survival of breast cancer in a teaching hospital in North Central Nigeria. Afr J Health Sci. 2009;9(1):15–19.
27. Mandong BM, Manasseh AN, Madaki AK, Tanko MN. Malignant diseases in Jos: A follow-up of histopathologic diagnoses in a tertiary hospital. Niger Postgrad Med J. 2001;8(3):111–115.
28. Olatunji AO, Agodirin SO, Rahman GA. Surgical management of breast cancer: A 15-year retrospective study of 145 patients in Ilorin, Nigeria. Niger J Clin Pract. 2012;15(1):85–89.
