Clinical presentation of breast cancer in a tertiary health facility in Niger-Delta Region of Nigeria: a three-year experience of practitioners

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Solomon N. Elenwo
Rex Friday Ogoronte Alderton Ijah
Ibifuro A. Green


Introduction: In the year 2022, breast cancer accounted for 11.6% of all cancers, trailing lung cancer (12.4%).  The aim of this study was to evaluate the clinical presentation of breast cancer patients in a tertiary health facility over a three-year period.

Methods: A hospital-based longitudinal study was carried out in breast clinic of a tertiary healthcare centre among patients who had breast cancer. Data was collected using a proforma, and data was analysed using United States CDC Epi- Info version 7 for statistical analysis. Categorical variables were presented as counts/percentages, and Spearman’s correlation for correlation.

Results: The mean age of patients was 43.13 ± 11.60 years, and the median parity was 3.00. Thirty-nine (63.9%) had breast lumps, and 10 (16.4%) had breast swelling as a presenting symptom. The mean duration of symptoms was 1 year. Twenty-four patients (39.3%) had no reason for late presentation, 15 (24.6%) due to ignorance, 13 (21.3%) due to inappropriate medical attention, and others were religion, self-medication, fear of mastectomy, financial constraints, lack of time, and use of native treatment. The majority of the patients (n = 34; 55.7%) were seen at stage III disease, and there was no statistically significant relationship between the duration of symptoms and clinical staging of the disease.

Conclusion: We report breast cancer occurrence mostly among relatively young multiparous, women, who had a mean symptom duration of 1 year, with the majority having stage III disease. There is a need for some form of regulation on cancer care to improve outcomes.


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Elenwo, S. N., Ijah, R. F. O. A., & Green, I. A. . (2024). Clinical presentation of breast cancer in a tertiary health facility in Niger-Delta Region of Nigeria: a three-year experience of practitioners. African Journal of Research in Medical and Health Sciences, 2(1), 38-44.
Author Biographies

Solomon N. Elenwo, Department of Surgery, Rivers State University / University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.

Professor, Department of Surgery

Ibifuro A. Green, Department of Surgery, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.

Consultant General Surgeon, Department of Surgery


Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2024.

Katsura C, Ogunmwonyi I, Kankam HK, Saha S. Breast cancer: presentation, investigation and management. British Journal of Hospital Medicine. 2022;83(2):1-7.

Arzanova E, Mayrovitz HN. The Epidemiology of Breast Cancer. Exon Publications. 2022:1-19.

Roheel A, Khan A, Anwar F, Akbar Z, Akhtar MF, Imran Khan M, et al. Global epidemiology of breast cancer based on risk factors: a systematic review. Frontiers in Oncology. 2023;13: 1-15. DOI 10.3389/fonc.2023.1240098

Yang Y, Sun N, Yu M, Yang C, Wang Y, Shi X, et al. A detailed quantitative analysis of the global, regional, and national burden of breast cancer over the past 30 years: estimates from the Global Burden of Disease study 2019. Journal of Public Health. 2023:1-12.

Fuentes JDB, Morgan E, de Luna Aguilar A, Mafra A, Shah R, Giusti F, et al. Global Stage Distribution of Breast Cancer at Diagnosis: A Systematic Review and Meta-Analysis. JAMA oncology. 2024;10(1):71-78. doi:10.1001/jamaoncol.2023.4837

Sun Y-S, Zhao Z, Yang Z-N, Xu F, Lu H-J, Zhu Z-Y, et al. Risk factors and preventions of breast cancer. International journal of biological sciences. 2017;13(11):1387-1397.

Andreopoulou E, Kelly CM, McDaid HM. Therapeutic advances and new directions for triple-negative breast cancer. Breast Care. 2017;12(1):20-27.

Wesolowski J, Tankiewicz-Kwedlo A, Pawlak D. Modern immunotherapy in the treatment of triplenegative breast cancer. Cancers. 2022;14(16):3860. DOI: 10.3390/cancers15112908

Kolářová I, Melichar B, Vaňásek J, Sirák I, Petera J, Horáčková K, et al. Special techniques of adjuvant breast carcinoma radiotherapy. Cancers. 2022;15(1):298-315.

Chhikara BS, Parang K. Global Cancer Statistics 2022: the trends projection analysis. Chemical Biology Letters. 2023;10(1):451-467.

Obidiro O, Battogtokh G, Akala EO. Triple negative breast cancer treatment options and limitations: future outlook. Pharmaceutics. 2023;15(7):1796-1822.

Sakai T, Kutomi G, Shien T, Asaga S, Aruga T, Ishitobi M, et al. The Japanese Breast Cancer Society Clinical Practice Guidelines for surgical treatment of breast cancer, 2022 edition. Breast Cancer. 2024;31(1):1-7.

Abbas N, Pathak R, Sarin R, Wadasadawala T, Krishnamurthy R. Woman Cancer Initiative-TMH-EBM conference. 2024. Annals of Oncology Research and Therapy 4(suppl 1):p S21-S34. DOI: 10.4103/aort.aort_8_24

Gavet O, Pines J. Progressive activation of CyclinB1-Cdk1 coordinates entry to mitosis. Developmental cell. 2010;18(4):533-543.

Mughal MJ, Bhadresha K, Kwok HF, editors. CDK inhibitors from past to present: A new wave of cancer therapy. Seminars in Cancer Biology. 2023; (88):106-122.

Warrior S, Cohen-Nowak A, Kumthekar P. Modern Management and Diagnostics in HER2+ Breast Cancer with CNS Metastasis. Cancers. 2023;15(11):2908.

Vanderpuye V, Grover S, Hammad N, Pooja Prabhakarn, Simonds H, Olopade F, et al. An update on the management of breast cancer in Africa. Infectious agents and cancer. 2017;12:1-12. DOI 10.1186/s13027-017-0124-y

Soliman A. Epidemiologic and clinical profiles of breast diseases in Niger. Int J Cancer Oncol. 2015;2:1-6.

Cazap E, Magrath I, Kingham TP, Elzawawy A.Structural barriers to diagnosis and treatment of cancer inlow-and middle-income countries: the urgent need forscaling up. Journal of Clinical Oncology. 2016;34(1):14-34. DOI: 10.1200/JCO.2015.61.9189

Galukande M, Wabinga H, Mirembe F, Karamagi C, Asea A. Molecular breast cancer subtypes prevalence in an indigenous Sub Saharan African population. The Pan African Medical Journal. 2014;17-24.

Dye TD, Bogale S, Hobden C, Tilahun Y, Hechter V, Deressa T, et al. Complex care systems in developing countries: breast cancer patient navigation in Ethiopia. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2010;116(3):577-585.

Clegg-Lamptey J, Dakubo J, Attobra Y. During treatment in Ghana? A pilot study. Ghana medical journal. 2009;43(3): 127-131.

Ezeome E. Delays in presentation and treatment of breast cancer in Enugu, Nigeria. Nigerian journal of clinical practice. 2010; 13 (3):311-316.

Yap Y-S, Lu Y-S, Tamura K, Lee JE, Ko EY, Park YH, et al. Insights into breast cancer in the east vs the west: a review. JAMA oncology. 2019;5(10):1489-1496.

Nam Y-H. A Study on the Factors and Prediction Model of Triple-Negative Breast Cancer for Public Health Promotion. Diagnostics. 2023;13(22):3486-3500.

Obidiro O, Battogtokh G, Akala E. Triple Negative Breast Cancer Treatment Options and Limitations: Future Outlook. Pharmaceutics. 2023; 15(7): 1796-1822.

Prakash O, Hossain F, Danos D, Lassak A, Scribner R, Miele L. Racial disparities in triple negative breast cancer: a review of the role of biologic and non-biologic factors. Frontiers in Public Health. 2020;8:576964.

Dogan I, Aksoy S, Cakar B, Basaran G, Ercelep O, Molinas Mandel N, et al. Demographic and Clinical Features of Patients with Metastatic Breast Cancer: A Retrospective Multicenter Registry Study of the Turkish Oncology Group. Cancers. 2023;15(6):1667.

Lv L, Zhao B, Kang J, Li S, Wu H. Trend of disease burden and risk factors of breast cancer in developing countries and territories, from 1990 to 2019: Results from the Global Burden of Disease Study 2019. Frontiers in Public Health. 2023;10:1078191.

Fitzmaurice C, Collaboration GBoDC. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 2006 to 2016: A systematic analysis for the Global Burden of Disease study. JAMA Oncol. 2018;4(11):1553-1568. doi:10.1001/jamaoncol.2018.2706.

Mrabti H, Sauvaget C, Benider A, Bendahhou K, Selmouni F, Muwonge R, et al. Patterns of care of breast cancer patients in Morocco–A study of variations in patient profile, tumour characteristics and standard of care over a decade. The Breast. 2021;59:193-202.

Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. The British journal of radiology. 2022;95(1130):20211033.

El Saghir NS, Khalil MK, Eid T, El Kinge AR, Charafeddine M, Geara F, et al. Trends in epidemiology and management of breast cancer in developing Arab countries: a literature and registry analysis. International journal of surgery. 2007;5(4):225-233.

Abahssain H, Lalya I, El M'rabet FZ, Ismaili N, Razine R, Tazi MA, et al. Breast cancer in moroccan young women: a retrospective study. BMC research notes. 2010;3:1-9.

Olasehinde O, Alatise O, Omisore A, Wuraola F, Odujoko O, Romanoff A, et al. Contemporary management of breast cancer in Nigeria: Insights from an institutional database. International Journal of Cancer. 2021;148(12):2906-29014.

Oguntunde PE, Adejumo AO, Okagbue HI. Breast cancer patients in Nigeria: data exploration approach. Data in brief. 2017;15:47-57.

Agbo S, Oboirien M, Gana G. Breast cancer incidence in Sokoto, Nigeria. ISDS Journals. 2013;2(2):1614-1622.

Esan DT, Fasoro AA, Olatoye OE, Ojo EF, Esan TO. Breast cancer trend: a case study of a tertiary health institution in Nigeria. Middle East Journal of Cancer. 2018;9(4): 311-317.

Ebughe GA, Ugare GU, Nnoli MA, Bassey I-A, Nwagbara VJ, Udosen J, et al. Histological type and tumour grade in Nigerian breast cancer: Relationship to menarche, family history of breast cancer, parity, age at first birth, and age at menopause. IOsR J dent Med sci.


Sighoko D, Ogundiran T, Ademola A, Adebamowo C, Chen L, Odedina S, et al. Breast cancer risk after full‐term pregnancies among African women from N igeria, Cameroon, and Uganda. Cancer. 2015;121(13):2237-2243.

Sayed S, Fan S, Moloo Z, Wasike R, Bird P, Saleh M, et al. Breast cancer risk factors in relation to molecular subtypes in breast cancer patients from Kenya. Breast Cancer Research. 2021;23(1):68-84.

Ebubedike UR, Nwammuo BCI, Umeh EO, Nwosu CS, Elendu KC, Umeokafor CC. Breast cancer in relation to gynecological risk factors among women in Southeast Nigeria. Journal of Radiation Medicine in the Tropics. 2022;3(2):57-62.

Shoeb MFR, Pinate AR, Shingade PP. Breast cancer, Clinical presentations, Risk factors, Staging. International Surgery Journal. 2017;4(2):645-649.

Mudduwa L, Wijesinghe C. Awareness of breast cancer among females with breast diseases. Galle Med J. 2008;13:14-18.

Sharma GN, Dave R, Sanadya J, Sharma P, Sharma K. Various types and management of breast cancer: an overview. Journal of advanced pharmaceutical technology & research. 2010;1(2):109-126.

Ayoade B, Agboola A, Olatunji A, Tade A, Salami B, Adekoya A. Clinical characteristics and survival outcome of breast cancer in Southwest Nigerian women. Journal Africain du Cancer/African Journal of Cancer. 2014;2(6):79-84.

Abiodun AM. Pattern of breast cancer presentation in a tertiary hospital in Lagos, Nigeria. World Journal of Advanced Research and Reviews. 2020;5(2):048-59.

Adesunkanmi A, Lawal O, Adelusola K, Durosimi M. The severity, outcome and challenges of breast cancer in Nigeria. The breast. 2006;15(3):399-409.

Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E. Breast cancer in young women: clinicopathological features and biological specificity. The Breast. 2003;12(4):247-250.

Axelrod D, Smith J, Kornreich D, Grinstead E, Singh B, Cangiarella J, et al. Breast cancer in young women. Journal of the American College of Surgeons. 2008;206(6):1193-1203.

Assi HA, Khoury KE, Dbouk H, Khalil LE, Mouhieddine TH, El Saghir NS. Epidemiology and prognosis of breast cancer in young women. Journal of thoracic disease. 2013;5(Suppl 1):S2. doi: 10.3978/j.issn.2072-1439.2013

Olaogun JG, Agodirin OS, Idowu DB. Patient delay in initiating treatment after breast cancer diagnosis: A cause for concern. Journal of Health Science Research.1-5.

Ibrahim N, Oludara M. Socio-demographic factors and reasons associated with delay in breast cancer presentation: a study in Nigerian women. The Breast. 2012;21(3):416-418.

Fujii T, Yajima R, Morita H, Suto T, Tatsuki H, Tsutsumi S, et al. Implication of duration of clinical presentation on tumor progression and short‑term recurrence in patients with early breast cancer. Molecular and Clinical Oncology. 2015;3(4):785-788.

McGee SA, Durham DD, Tse C-K, Millikan RC. Determinants of breast cancer treatment delay differ for African American and White women. Cancer epidemiology, biomarkers & prevention. 2013;22(7):1227-1238.

Ghumro AA, Khaskheli NM, Memon AA, Ansari AG, Awan M. Clinical profile of patients with breast cancer. JOURNAL-COLLEGE OF PHYSICIANS AND SURGEONS OF PAKISTAN. 2002;12:28-31.

Donkor A, Lathlean J, Wiafe S, Vanderpuye V, Fenlon D, Yarney J, et al. Factors contributing to late presentation of breast cancer in Africa: a systematic literature review. Archives of Medicine. 2015;8(2.2):1-10.

Espina C, McKenzie F, dos-Santos-Silva I. Delayed presentation and diagnosis of breast cancer in African women: a systematic review. Annals of epidemiology. 2017;27(10):659-71. e7.

Agodirin OS, Aremu I, Rahman GA, Olatoke SA, Akande HJ, Oguntola AS, et al. Prevalence of themes linked to delayed presentation of breast cancer in Africa: a meta-analysis of patient-reported studies. JCO global oncology. 2020;6:731-742.

Ukwenya A, Yusufu L, Nmadu P, Garba E, Ahmed A. Delayed treatment of symptomatic breast cancer: the experience from Kaduna, Nigeria. South African Journal of Surgery. 2008;46(4):106-110.

Pruitt L, Mumuni T, Raikhel E, Ademola A, Ogundiran T, Adenipekun A, et al. Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria. Global public health. 2015;10(3):331-344.

Sharma K, Costas A, Shulman LN, Meara JG. A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. Journal of oncology. 2012; 1-8. doi:10.1155/2012/121873

Somanna SN, Srinivasa MN, Cheluvarayaswamy R, Malila N. Time interval between self-detection of symptoms to treatment of breast cancer. Asian Pacific journal of cancer prevention: APJCP. 2020;21(1):169-174. DOI:10.31557/APJCP.2020.21.1.169

Rossi S, Cinini C, Di Pietro C, Lombardi CP, Crucitti A, Bellantone R, et al. Diagnostic delay in breast cancer: correlation with disease stage and prognosis. Tumori Journal. 1990;76(6):559-562.

Huo Q, Cai C, Zhang Y, Kong X, Jiang L, Ma T, et al. Delay in diagnosis and treatment of symptomatic breast cancer in China. Annals of surgical oncology. 2015;22:883-888.

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