Breast Cancer among Urban Nigerian Women: Appraising Presentation and the Quality of Care

Introduction:  Late presentation is the hallmark of breast cancer among Nigerians. Awareness of the disease is low and care of this condition has not received adequate attention from Government. Health education to improve awareness was intensified in the last 2 decades. This study aims to assess the current state of care and presentation of breast cancer in Lagos, Nigeria. Patients and Methods:  A prospective study of 350 breast cancer patients seen over a period of four years at a General Surgical unit out-patient clinic of LASUTH was carried out. Data on patient characteristics, presentation, diagnosis and treatment were obtained and analyzed. Results:  Average duration of symptoms was 46.48 weeks. One fifth presented within 3 months while 17% presented after 1 year. Lumps were self-detected in 96% and 287 (82%) presented with advanced disease (stages III & IV). Two hundred and thirty seven patients (67%) received treatment and 175 (74%) among them had mastectomy. None had breast conservation surgery. One hundred and fourteen patients (48%) absconded and did complete treatment. Conclusion:  The trend of late presentation has not changed with current efforts to improve breast cancer awareness. Quality of care for our breast cancer patients is not satisfactory and needs improvement.