Breast cancer conservation therapy in Sub-Saharan Africa: Between constraints and prospects

Objective: To describe the epidemiological profile, diagnostic aspects and evaluate the treatment strategy for breast cancer patients treated with breast conserving therapy. 

Methods: We conducted a retrospective descriptive study of all patients who underwent breast cancer conserving therapy in the radiotherapy department of the Dalal Jamm Hospital in Senegal from January 2021 to December 2024. Epidemiological, diagnostic, and therapeutic variables were systematically analyzed. 

Results: During the study period, 46 patients with breast cancer were treated with breast conserving therapy, representing 6.54% of cases. Age range was 26 to 67 years, with a mean of 43.8 years. T2-classified tumors were the most common (41.30%). Non-specific invasive ductal carcinoma was found in 93.5% of cases. All patients underwent lumpectomy with negative margins in 41 cases (91.1%). Neoadjuvant Chemotherapy was administered in 95.6% of cases. The average duration between surgery and the start of radiotherapy was 7.7 months. Hypofractionated radiotherapy delivering a total dose of 42 Gy in 15 fractions of 2.8 Gy was used in all patients. Radiodermatitis was the most common acute toxicity (58.7%) of radiotherapy. Locoregional recurrence was found in 2 cases and metastatic recurrence in 6 patients, or 13.04% of cases.

Conclusion: Breast cancer conserving therapy is still struggling to be popularized in sub-saharan Africa due to late diagnosis and difficult access of radiotherapy.