S. Myint1, T. Lwin1, A. L. Kushner2,3, W. Yee1, K. Khaing1, S. Mon1, T. Lwin1 1university of medicine (1), Yangon,Department Of Surgery,Yangon, YANGON, Myanmar 2Columbia University College Of Physicians And Surgeons,New York, NY, USA 3Johns Hopkins Bloomberg School Of Public Health,Department Of International Health,Baltimore, MD, USA
Introduction:
Breast cancer is a global problem and management in low income countries is difficult. Myanmar, with a population of 60 million is one of the poorest. Most surgical care is performed in the capital Yangon. To improve breast cancer care, we evaluated the management of locally advanced breast cancer (LABC).
Methods:
Patient charts for surgical admissions with a diagnosis of breast cancer from January 1 to December 31, 2013 at the Yangon General Hospital and the New Yangon General Hospital were reviewed. Data were recorded for patients with a diagnosis of LABC.
Results:
A total of 225 breast cancer patients were identified with 105(47%) diagnosed with LABC. Thirty two (30%) were younger than 45 and 7 (7%) older than 65. Biopsy was: fine needle in 10, incisional biopsy in 36, core needle in 50, and wedge biopsy in 9. On histology, 90(86%) invasive ductal carcinoma and 15(14%) invasive lobular. Estrogen receptors were positive in 46%, progesterone receptors positive in 44% and Her2µ positive in 45%. All patients underwent a mastectomy. Adjuvant therapy was given to 80, neo-adjuvant to 10 and 28 had hormonal. Postoperatively 34 developed a seroma and 7 had a surgical site infection.
Conclusion:
LABC contributes to a large proportion of breast cancer cases in Myanmar leading to significant surgical morbidity. With earlier diagnosis morbidity and mortality can be reduce. Breast cancer awareness should be promoted and screening programs warrant exploration. Also ongoing evaluation of surgical care for these patients and additional research is warranted.
