Cancer du sein en Afrique subsaharienne : des disparités fondées sur l’ethnicité

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Épidémiologie des cancers digestifs primitifs de l’adulte dans trois centres sanitaires spécialisés de Cotonou (République du Bénin)

International audienceHealth research studies are increasingly focusing on digestive cancers because of their increasing frequency and severity. The objective of this work was to study the epidemiological aspects of primary digestive cancers in adults in three hospital centers in the commune of Cotonou. A total of 676 cases of digestive cancers were identified out of 25,093 patients received during the study period (2.7%). The mean age was 54 ± 14.1 years: [16-96] and the sex ratio was 2:1. The most frequent cancers were those of the liver (259; 38.3%) and colon-rectum (154; 22.8%). The next most common cancers in descending order were gastric cancer (12%), esophageal cancer (11.4%), pancreatic cancer (11.4%), anal cancer (1.9%), hail cancer (1.5%) and biliary cancer (0.7%). The average time to visit was 9 months. The main risk factors found were viral hepatitis B and C, alcoholism, diabetes, obesity, colonic polyps, smoking, excessive consumption of salt and dietary nitrates. Lethality was 58.4%, with cancers of the liver, colon-rectum, pancreas, and esophagus in descending order of mortality. The average overall survival was 10 months. Digestive cancers most often affect people in their fifties, who are usually men in Cotonou. They are dominated by liver cancer and colorectal cancer. Modifiable risk factors are often found. The control of these factors and early diagnosis could help improve the survival of patients affected

Surgical management of erosive adenomatosis of the nipple: A case report

International audienceIntroduction and importance: Known as a very uncommon disease, erosive adenomatosis of the nipple is a benign neoplasm of the breast. However, its destructive process can have a considerably negative impact on patient's quality of life.Case presentation: We report the case of a 45-year-old woman who presented at the visceral surgery department of the National Teaching Hospital of Cotonou-Benin (CNHU-HKM) for a burgeoning mass of the left nipple. She was diagnosed an erosive adenomatosis of the nipple and underwent a nipple resection with reconstruction.Clinical discussion: Erosive adenomatosis is one differential diagnosis for lesion of the nipple. Clinically, it should be discussed with malignant nipple tumours including Paget's disease.Conclusion: Surgery is the cornerstone of the treatment, and the prognosis is excellent

Connaissances, Attitudes et Pratiques des médecins généralistes sur le cancer du sein dans le département du Littoral en République du Bénin

International audienceLe cancer du sein est le cancer le plus diagnostiqué au monde et la première cause de décès par cancer chez la femme. Bien que l'incidence en Afrique au sud du Sahara soit la plus faible au monde, la mortalité y est la plus élevée. Au Bénin, les médecins généralistes (MG) sont parmi les premiers acteurs de la prise en charge. Notre objectif était d'évaluer les connaissances, attitudes et pratiques (CAP) des MG sur le cancer du sein dans le département du Littoral au Sud du Bénin

Cancers du pancréas au Centre National Hospitalier Universitaire de Cotonou: aspects épidémiologiques, diagnostiques, thérapeutiques et pronostiques

International audienceIntroduction: cancer is a major cause of death in the world. The purpose of this study is to evaluate the epidemiological, clinical, therapeutic and prognostic features of cancers of the pancreas (CP) at the National Hospital and University Center of Cotonou.Methods: we conducted a cross-sectional descriptive and analytical study with a prospective and retrospective data collection over a period of ten years, from 1 October 2009 to 31 October 2019.Results: out of 15.102 hospitalizations, we identified 72 cases of CP, reflecting a hospitalization rate of 0.5%. The average age of patients was 59 years. The sex-ratio (H/F) was 1.5. The main reason for consultation was abdominal pain. More than half (51.4%) of patients had metastatic tumor at the time of diagnosis. Histological evidence of adenocarcinoma was only reported in 15.1% of cases. The rate of operable patients was 37.5% while the rate of resectable patients was 2.7%. Palliative chemotherapy was given to 13.9% of patients. The average cost of treatment was 955.882,4 FCFA (23.9 times the Guaranteed Interprofessional Minimum Wage in Benin). Median overall survival was 6 months. Mortality rate was 86.9% (53/61), survival rate at one year was 31.4%, and zero at five years. Palliative surgery (p = 0.021) and chemotherapy (p = 0.023) improved patient survival.Conclusion: cancer of the pancreas, due to its non-specific signs and insidious outcome, is often diagnosed at a late stage. A metastatic tumor and the limited individual and institutional therapeutic possibilities lead to more pejorative prognosis

Accès au traitement du cancer du sein chez les femmes en population générale à Cotonou

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Aspects cliniques et thérapeutiques des sarcomes à Cotonou

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Conformité des formulaires de demande et des comptes rendus anatomopathologiques de pièces opératoires de cancer du sein au Bénin

International audienceAdequacy of histopathology request forms and pathological reports of breast cancer surgical specimens in Benin Introduction. Le cancer du sein requiert une prise en charge pluridisciplinaire. Les anatomopathologistes et les médecins communiquent grâce au formulaire de demande et au compte rendu d’examen anatomopathologique. Il est crucial que ces deux documents soient bien rédigés pour une bonne prise en charge des patientes. Objectif. Évaluer la complétude des formulaires de demande et des comptes rendus d’examen anatomopathologique de pièces opératoires de cancers du sein chez les femmes au Sud du Bénin. Méthode. Il s’agissait d’une étude transversale, descriptive et analytique, avec une collecte rétrospective de données sur 57 mois (4 ans et 9 mois). Nous avons utilisé les recommandations de la Haute Autorité de Santé de France comme référentiel et le logiciel SPSS pour traiter les données. Résultats. 31,3 % des formulaires de demande étaient conformes aux recommandations. Les comptes rendus étaient narratifs dans 92,7 % des cas et 68,8 % comportaient les critères minimaux. La présence d’emboles vasculaires, le statut HER2 et les récepteurs hormonaux étaient tous simultanément renseignés dans seulement 29,2 % des comptes rendus. La présence d’emboles vasculaires était le facteur pronostique le plus souvent renseigné. Discussion. Les chirurgiens et les anatomopathologistes ne rédigent pas toujours entièrement les formulaires de demande et les comptes rendus d’examen anatomopathologique. Ceci peut s’expliquer par l’absence de référentiels nationaux, et les difficultés d’accès à l’immunohistochimie. L’élaboration de référentiels nationaux et l’utilisation de comptes rendus synoptiques pourraient améliorer les pratiques. Conformité des formulaires de demande et des comptes rendus anatomopathologiques de pièces opératoires de cancer du sein au Bénin Introduction. Breast cancer requires multidisciplinary management. Pathologists and physicians commu-nicate using the histopathology request form and the pathology report. There are some minimal criteria that both should respect. Objective. We assessed the adequacy of histopathology request forms and pathology reports in the ma-nagement of female breast cancer specimens in Southern Benin. Method. This was a cross-sectional, descriptive and analytical study, with retrospective data collection over 57 months (4 years and 9 months). The adequacy of the histopathology request forms and patho-logy reports was assessed on the basis of the recommendations of the Haute Autorité de Santé (HAS) of France. Data processing was done using SPSS software. We checked frequencies with the Chi² test, with a significance level set at 5%. Results. 31.3% of histopathology request forms complied with HAS recommendations. Pathology re-ports were presented in a narrative way in 92.7% of cases and 68.8% met the minimal criteria. The pre-sence of vascular embolus, of hormone receptors and the HER2 status were all reported in only 29.2% of the reports. Discussion. The draft of histopathology request forms and pathology reports did not comply to the re-quired minimal criteria. This situation could mainly be explained by the inexistence of consensus between physicians and pathologists and by the lack of immunohistochemistry. Editing national referentials and using synoptic reports would give better results.R ÉSU M É Introduction. Le cancer du sein requiert une prise en charge pluridisciplinaire. Les anatomopathologistes et les médecins communiquent grâce au formulaire de demande et au compte rendu d'examen anatomopathologique. Il est crucial que ces deux documents soient bien rédigés pour une bonne prise en charge des patientes. Objectif. Évaluer la complétude des formulaires de demande et des comptes rendus d'examen anatomopathologique de pièces opératoires de cancers du sein chez les femmes au Sud du Bénin. Méthode. Il s'agissait d'une étude transversale, descriptive et analytique, avec une collecte rétrospective de données sur 57 mois (4 ans et 9 mois). Nous avons utilisé les recommandations de la Haute Autorité de Santé de France comme référentiel et le logiciel SPSS pour traiter les données. Résultats. 31,3 % des formulaires de demande étaient conformes aux recommandations. Les comptes rendus étaient narratifs dans 92,7 % des cas et 68,8 % comportaient les critères minimaux. La présence d'emboles vasculaires, le statut HER2 et les récepteurs hormonaux étaient tous simultanément renseignés dans seulement 29,2 % des comptes rendus. La présence d'emboles vasculaires était le facteur pronostique le plus souvent renseigné. Discussion. Les chirurgiens et les anatomopathologistes ne rédigent pas toujours entièrement les formulaires de demande et les comptes rendus d'examen anatomopathologique. Ceci peut s'expliquer par l'absence de référentiels nationaux, et les difficultés d'accès à l'immunohistochimie. L'élaboration de référentiels nationaux et l'utilisation de comptes rendus synoptiques pourraient améliorer les pratiques. Mots clés : Cancer du sein, Chirurgie oncologique, Conformité, Formulaire de demande d'examen, Compte rendu d'examen anatomopathologique, Bénin, Afrique subsaharienne A BST R AC T Introduction. Breast cancer requires multidisciplinary management. Pathologists and physicians communicate using the histopathology request form and the pathology report. There are some minimal criteria that both should respect. Objective. We assessed the adequacy of histopathology request forms and pathology reports in the management of female breast cancer specimens in Southern Benin. Method. This was a cross-sectional, descriptive and analytical study, with retrospective data collection over 57 months (4 years and 9 months). The adequacy of the histopathology request forms and pathology reports was assessed on the basis of the recommendations of th

Ensuring Global Access to Cancer Medicines: A Generational Call to Action

International audienceEssential cancer treatments are not accessible, affordable, or available to patients who need them in many parts of the world. A new Access to Oncology Medicines (ATOM) Coalition, using public–private partnerships, aims to bring essential cancer medicines and diagnostics to patients in low-and lower middle-income countries

Prognostic factors and overall survival of breast cancer in Benin: a hospital-based study

International audienceBackgroundIn Benin, a country in West Africa, breast cancer is the leading cancer in women, both in terms of incidence and mortality. However, evidence on the mortality of breast cancer and its associated factors is lacking in this country. Our aim was to describe and analyze the clinical, histopathological, and prognostic aspects of breast cancer in Benin.MethodsA descriptive and analytical study was carried out at the CNHU-HKM and the CHU-MEL, two major tertiary referral hospitals for breast cancer management located in Cotonou, the capital city of Benin. All breast cancer medical records with histological evidence and immunohistochemistry studies were retrospectively collected between January 1, 2014, and September 30, 2020, in these two tertiary referral hospitals and analyzed in the current study.ResultsFinally, 319 medical records were included. The mean age at diagnosis was 48.74 years. The tumors were most frequently classified as T4 (47.6%) with lymph node involvement N2 (34.5%), and metastases were clinically noted in 21.9% of cases. Stage was reported in the medical records of 284 patients. Tumors were diagnosed at very late AJCC stages: stage III (47.5%) and stage IV (24.7%). Grades SBR 2 (49.2%) and SBR 3 (32.6%) were the most frequent grades. Triple-negative breast cancer (31.3%) was the most common molecular type. The overall 5-year survival was 48.49%. In multivariable analysis, the poor prognostic factors were lymph node invasion (HR = 2.63; p = 0.026; CI: [1.12, 6.17]), the presence of metastasis (HR = 3.64; p < 0.001); CI: [2.36, 5.62] and the immunohistochemical profile (HR = 1.29; p < 0.001; CI: [1.13, 1.48]).ConclusionsBreast cancer in Beninese is predominant in young adults and is often diagnosed at a late stage. The survival of breast cancer patients in Benin can be improved by enhancing early diagnosis and multidisciplinary management