Journal articles: 'Breast cancer south africa'

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Trupe, Lydia A., Anne Rositch, Lindsay Dickerson, Su Lucas, and Susan C. Harvey. "Knowledge and Attitudes About Breast Cancer in Limpopo, South Africa." Journal of Global Oncology 3, no. 5 (October 2017): 509–14. http://dx.doi.org/10.1200/jgo.2016.008102.

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Purpose Breast cancer survival is unacceptably low in many low-resource settings, including rural South Africa, where access to screening and treatment services is limited. To describe the context for implementing an early detection program, we assessed knowledge and attitudes toward breast cancer risk, early detection, and treatment. Methods We conducted a cross-sectional survey among 243 women presenting to Hlokomela Clinic in Hoedspruit, South Africa, during April and May 2016. We used quantitative and qualitative analyses to determine levels of knowledge of risk factors, symptoms, and treatment of breast cancer, as well as experience with and attitudes toward detection and treatment methods. Results Thirty-one percent of women correctly identified at least six of 12 risk factors for breast cancer, and 53.1% identified breast lumps as an important symptom. Although > 97% of women stated that self–breast examination and early detection were highly important and that they would seek care for changes in their breasts, only 33.3% of women reported performing self–breast examination, and only 24.3% reported receiving a clinical breast examination. Age and education were not associated with knowledge, and level of knowledge did not predict care-seeking behaviors or attitudes. Conclusion Although women demonstrated moderate levels of knowledge of breast cancer symptoms and risk factors and the importance of early detection, few women reported seeking services. These data demonstrate sufficient levels of knowledge and positive attitudes toward care seeking and suggest both a need and readiness for increased access to cost-effective services to facilitate early diagnosis and improved outcomes.

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Lambert, Madeleine, Emily Mendenhall, Andrew Wooyoung Kim, Herbert Cubasch, Maureen Joffe, and Shane A. Norris. "Health system experiences of breast cancer survivors in urban South Africa." Women's Health 16 (January 2020): 174550652094941. http://dx.doi.org/10.1177/1745506520949419.

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Background: Breast cancer is the most common cancer globally and among South African women. Women from socioeconomically disadvantaged South African communities more often present later and receive total mastectomy compared to those from more affluent communities who have more breast conserving surgery (which is less invasive but requires mandatory radiation treatment post-operatively). Standard chemotherapy and total mastectomy treatments are known to cause traumatizing side effects and emotional suffering among South African women; moreover, many women face limited communication with physicians and psychological support. Objective: This article investigates the experiences of women seeking breast cancer treatment at the largest public hospital in South Africa. Methods We interviewed 50 Black women enrolled in the South African Breast Cancer Study to learn more about their health system experiences with detection, diagnosis, treatment, and follow-up care for breast cancer. Each interview was between 2–3 hours, addressing perceptions, experiences, and concerns associated with breast cancer and comorbidities such as HIV and hypertension. Results: We found most women feared diagnosis, in part, because of the experience of chemotherapy and physical mutilation related to mastectomy. The importance of social support from family, religion, and clinical staff was fundamental for women coping with their condition and adhering to treatment and medication. Conclusions: These findings exemplify how interventions might promote early detection of breast cancer and better adherence to treatment. Addressing community perceptions of breast cancer, patient needs and desires for treatment, structural barriers to intensive therapies, and the burden of invasive treatments are imperative next steps for delivering better breast cancer care in Soweto and other resource-constrained settings.

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Prodehl, Leanne, and Carol Benn. "Triple negative breast cancer in a South African urban breast care centre." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e13067-e13067. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e13067.

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e13067 Background: Triple negative breast cancer (TNBC) is associated with advanced stage at presentation, aggressive tumour biology and poor outcomes. There is no published data for South Africa. Methods: A retrospective file review of TNBC cases at the Milpark Breast Care Unit in Johannesburg, South Africa, data were collected on presentation, treatment and outcomes. A prospective file review and telephonic interview were done for further follow up. Results: There were 196 patients with TNBC identified out of 1407 patients (13.9%), 135 patients were analysed. Stage at presentation was IIa and IIb in approximately half (46.7%) of the patients and IIIa, IIIb and IV in a third (31.8%). Patients presented with large tumours -71.8% were T2 to T4; and lymph node positive disease (55.6%). The majority of patients had high-grade, poorly differentiated tumours. The challenges when treating TNBC were reflected in the use of multimodality therapy; 92.2% of patients had chemotherapy, as neoadjuvant (59.3%), adjuvant or both. There were 93 (68.9%) patients treated with adjuvant radiation therapy. If neoadjuvant chemotherapy was given 91.2% had a response. Recurrences occurred in 33 patients, with a 5-year disease free survival of 72.5%, and preponderance to visceral metastases (45.2%). Recurrences occurred early, the median was 23.1 months and all had occurred within eight years. Younger patients (HR 1.58), tumour size and lymph node positivity (HR 4.42) were associated with increased risk of recurrence, but only lymph node positivity was significant (HR 4.42). Complete pathological response to neoadjuvant chemotherapy was associated with fewer recurrences if no tumour was found in either the breast or the lymph nodes (HR 0.33). The 5-year overall survival was 76.4%. There was no significant difference in survival for age, node status, nuclear grade, or complete pathological response, only tumour size at presentation was significantly associated. Conclusions: The prevalence of triple negative breast cancer in a South African breast care unit was similar to some European studies but less than studies in West and East Africa. Patients presented at an advanced stage and had poorer outcomes than luminal breast cancers.

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Kiyange, F., V. Walusansa, G. Mandosela, H. Nzereka Kambale, E. Luyirika, and J. Orem. "The Role of South-to-South Partnerships in Developing Cancer Services in Africa." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 163s. http://dx.doi.org/10.1200/jgo.18.21200.

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Background and context: Despite being a growing public health concern in Africa, access to effective cancer treatment and pain relief is still limited in sub-Saharan Africa. The African Palliative Care Association (APCA) in collaboration with the American Cancer Society and the Ministry of Health of Swaziland have successfully implemented a South-to-South partnership which has facilitated the development and operation of a cancer unit in Mbabane National Hospital. Although the cancer burden continues to rise in Africa, many countries do not have established oncology services. They rely on cancer treatment, care and support through referral to neighboring countries or overseas, which is costly for governments and poses multiple challenges for patients and their families. Until recently, Swaziland has relied on cancer treatment and care in South Africa. This paper presents a model where the Uganda Cancer Institute (UCI) in Uganda has been facilitated to support the establishment of a cancer unit in Swaziland. Aim: The intervention aimed at providing technical assistance to the Ministry of Health of Swaziland to initiate and operate a cancer unit in Mbabane Government Hospital through a formal arrangement with the UCI. Strategy/Tactics: The planning and execution of activities was done by a tripartite of APCA, Uganda Cancer Institute a government entity and the Swazi Ministry of Health. Program/Policy process: Over a period of one year (Decemeber 2016 to December 2017) APCA, through a grant from the ACS formerly engaged the UCI to support the initiation and operation of a cancer unit in Swaziland. This was through expert exchange visits through which on-job training and mentorship was provided to a team of staff at Mbabane Government Hospital, with coordination by the Swaziland Ministry of Health. Experiential visits to Uganda were also organized for the lead pharmacist in Swaziland and a doctor to enable them set up and run a cancer unit in their country. The exchange visits provided a forum for both observation and application of knowledge and skills. Outcomes: A cancer unit was successfully established at Mbabane Government Hospital in Swaziland, which now provides services for patients, with breast cancer and expanding to include other cancers. The Swaziland Ministry of Health has been key to the success of this development and continues to identify human, financial and other resources to sustain the cancer unit. To date 69 patients have successfully undergone chemotherapy: 43 breast cancer, 22 Kaposi sarcoma, 2 colorectal cancer, 1 bladder cancer, 1 multiple myeloma. 21 health care workers were trained on cancer management; 9 doctors, 7 nurses and 5 pharmacists. What was learned: There are many opportunities for South-to-South partnership to support the establishment or improvement of cancer care. This model implemented in Swaziland can be replicated in other African countries. Documenting the model for replication in other countries is recommended.

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Jacobs, Inarie, Christine Taljaard-Krugell, Cristian Ricci, Hester Vorster, Sabina Rinaldi, Herbert Cubasch, Ria Laubscher, et al. "Dietary intake and breast cancer risk in black South African women: the South African Breast Cancer study." British Journal of Nutrition 121, no. 5 (February 1, 2019): 591–600. http://dx.doi.org/10.1017/s0007114518003744.

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AbstractIncidence rates of breast cancer (BC) are increasing in South Africa. The aim of this study was to investigate the association between dietary intake and BC risk in black South African women. The study population included 396 BC cases and 396 population-based controls matched on age and residence, participating in the South African Breast Cancer study. Diet was assessed using a validated quantified FFQ from which twelve energy-adjusted food groups were formed and analysed. OR were estimated using conditional logistic regressions, adjusted for confounding factors, comparing highestv.lowest median intake. Fresh fruit consumption showed an inverse association with BC risk (OR=0·3, 95 % CI 0·12, 0·80) in premenopausal women, whilst red and organ meat consumption showed an overall inverse association with BC risk (OR=0·6, 95 % CI 0·49, 0·94 and OR=0·6, 95 % CI 0·47, 0·91). Savoury food consumption (sauces, soups and snacks) were positively associated with BC risk in postmenopausal women (OR=2·1, 95 % CI 1·15, 4·07). Oestrogen receptor-positive stratification showed an inverse association with BC risk and consumption of nuts and seeds (OR=0·2, 95 % CI 0·58, 0·86). Based on these results, it is recommended that black South African women follow a diet with more fruit and vegetables together with a decreased consumption of less energy-dense, micronutrient-poor foods such as savoury foods. More research is necessary to investigate the association between BC risk and red and organ meat consumption. Affordable and practical methods regarding these recommendations should be implemented within health intervention strategies.

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Bosire, Edna N., Emily Mendenhall, and Lesley Jo Weaver. "Comorbid Suffering: Breast Cancer Survivors in South Africa." Qualitative Health Research 30, no. 6 (March 24, 2020): 917–26. http://dx.doi.org/10.1177/1049732320911365.

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Cycles of chronic illness are unpredictable, especially when multiple conditions are involved, and that instability can transform “normal” everyday life for individuals and their families. This article employs a theory of “comorbid suffering” to interpret how multiple concurrent diagnoses produce webs of remarkable suffering. We collected 50 life stories from breast cancer survivors enrolled in the South Africa Breast Cancer Study. We present three women’s narratives who grapple with comorbid suffering and illness-related work, which arise interpersonally when comorbid illnesses affects social interactions. We found that women strive to create a balance between living with comorbid suffering and continuously performing routine activities amid treatment. Discrimination and isolation were underpinned by women’s fear of being rejected by their families or how their illnesses created social distance between family members and the wider community. This study therefore illustrates how comorbid suffering requires intensive family commitments amid and beyond illness.

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Moodley, Shun Devan, Alicia McMaster, and Rashem Mothilal. "Taxpas: Epidemiological and Survival Data in Breast Cancer Patients Treated with a Docetaxel-Based Chemotherapy Regimen in South Africa." Journal of Cancer Research 2013 (December 11, 2013): 1–5. http://dx.doi.org/10.1155/2013/308236.

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Breast cancer is the leading cancer among South African women. There is limited South African epidemiological data on triple-negative breast cancer (TNBC). Taxpas was a nonrandomized observational survey conducted in multiple centres in South Africa from April 2004 to December 2010. 1632 female patients diagnosed with breast cancer, with a median age of 51 years, were enrolled in the survey. Patients were treated on a docetaxel-based chemotherapy regimen. The objective of the study was to assess epidemiological data and survival data. The incidence of TNBC was 14%. The one-year survival rate for the total cohort was 84%. The one-year survival rate for patients with early stage and metastatic breast cancer was recorded as 94% and 65%, respectively. Patients with TNBC stage III (all ages) and stage IV (≤50 years) had statistically significant worse 1-year survival rate compared to N-TNBC patients of the same age and stages. Conclusion. The incidence of TNBC in South Africa which is 14% is comparable to global incidence. The 1-year survival data for certain subgroups supports the literature saying that TNBC carries a worse prognosis compared to N-TNBC. Women ≤50 years diagnosed with late stage TNBC carried the worst prognosis in this survey.

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Saberian, Mehran, Kamran Mehrabani, and Hadi Raeisi Shahraki. "Clustering time trends of breast cancer incidence in Africa: a 27-year longitudinal study in 53 countries." African Health Sciences 21, no. 1 (April 16, 2021): 47–53. http://dx.doi.org/10.4314/ahs.v21i1.8.

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Background: Breast cancer is the most common, frequently diagnosed cancer with the highest incidence among female worldwide. Although the incidence is decreasing in developed countries, it is on increase in most of the African countries. Objective: This study aimed to identify different time trends of breast cancer incidence among African countries using latent mixture approach. Methods: The information includes newly diagnosed breast cancer patients per 100,000 women for 53 African countries in a period of 1990-2016. Latent mixture modeling was performed in Mplus 7.4 software. Results: The overall trend of breast cancer in Africa was increasing. Latent mixture model with 5 clusters was estimated as the best using fit indices and linear growth trajectories were specified for each cluster. Nigeria was the only country which belongs to a cluster with negative slope indicating a slow decrease in the breast cancer incidence; also, Seychelles was the only country that showed a sharp increase over time. 31 countries belonged to a cluster with a slope of 0.08, indicating that the incidence of breast cancer is almost constant over time. Cluster 3 including Algeria, Angola, Botswana, Central African Republic, Cote d’lvoire, Equatorial Guinea, Lesotho, Libya, Namibia, Somalia, Sudan, Swaziland, Uganda and Zimbabwe and cluster 2 including Gabon, Mauritius, Morocco, South Africa, Tunisia and Congo showed a slow and moderate increase in the incidence of breast cancer, respectively. Conclusion: Providing health education programs is essential in African countries with rising trend of breast cancer during the last decades. Keywords: Africa; breast cancer; incidence; latent mixture model; trend.

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Cubasch, Herbert, Paul Ruff, Maureen Joffe, Shane Norris, Tobias Chirwa, Sarah Nietz, Vinay Sharma, et al. "South African Breast Cancer and HIV Outcomes Study: Methods and Baseline Assessment." Journal of Global Oncology 3, no. 2 (April 2017): 114–24. http://dx.doi.org/10.1200/jgo.2015.002675.

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Purpose In low- and middle-income, HIV-endemic regions of sub-Saharan Africa, morbidity and mortality from the common epithelial cancers of the developed world are rising. Even among HIV-infected individuals, access to antiretroviral therapy has enhanced life expectancy, shifting the distribution of cancer diagnoses toward non–AIDS-defining malignancies, including breast cancer. Building on our prior research, we recently initiated the South African Breast Cancer and HIV Outcomes study. Methods We will recruit a cohort of 3,000 women newly diagnosed with breast cancer at hospitals in high (average, 20%) HIV prevalence areas, in Johannesburg, Durban, Pietermaritzburg, and Empangeni. At baseline, we will collect information on demographic, behavioral, clinical, and other factors related to access to health care. Every 3 months in year 1 and every 6 months thereafter, we will collect interview and chart data on treatment, symptoms, cancer progression, comorbidities, and other factors. We will compare survival rates of HIV-infected and uninfected women with newly diagnosed breast cancer and their likelihood of receiving suboptimal anticancer therapy. We will identify determinants of suboptimal therapy and context-specific modifiable factors that future interventions can target to improve outcomes. We will explore molecular mechanisms underlying potentially aggressive breast cancer in both HIV-infected and uninfected patients, as well as the roles of pathogens, states of immune activation, and inflammation in disease progression. Conclusion Our goals are to contribute to development of evidence-based guidelines for the management of breast cancer in HIV-positive women and to improve outcomes for all patients with breast cancer in resource-constrained settings.

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Odedina, Folakemi T., Delva Shamley, Ifeoma Okoye, Adaora Ezeani, Ntokozo Ndlovu, Yvonne Dei-Adomakoh, Kimberly Meza, Ruth Agaba, Parisa Fathi, and Nissa Askins. "Landscape of Oncology Clinical Trials in Africa." JCO Global Oncology, no. 6 (September 2020): 932–41. http://dx.doi.org/10.1200/jgo.19.00189.

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PURPOSE The burden of cancer in Africa is of significant concern for several reasons, including that incidence of cancer in Africa continues to rise while Africa is also dealing with communicable diseases. To combat cancer in Africa, oncology clinical trials are needed to develop innovative interventions for cancer prevention, screening, diagnosis, treatment, and survivorship. Unfortunately, there is a paucity of clinical trials in Africa and it is difficult for African clinicians to get information on open oncology clinical trials and impossible for African patients with cancer to access this information. The primary objective of this study was to identify open oncology clinical trials in Africa. METHODS This project was part of a large-scale study to develop an African Virtual Platform for Oncology Clinical Trials Registry. The study was a quantitative, web-based, retrospective review of clinical trials registries. RESULTS A total of 109 open oncology clinical trials were identified. Most of the trials were in Egypt, South Africa, Algeria, and Kenya. The top cancer types for oncology clinical trials in Africa were breast, cervical, and lung cancers. The top sponsor of oncology clinical trials in Africa was academic institutions, especially institutions in the United States. CONCLUSION The paucity of clinical trials in Africa will continue to magnify the global disparities of cancer in the African population. Clinical trials are needed to ensure therapeutic interventions are safe and effective in the African population. In the era of personalized and precision health, it no longer suffices to assume that drugs developed in North America, Europe, or Asia will be effective in the African population.

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Kayamba, Violet, Wilbroad Mutale, Holly Cassell, Douglas Corbett Heimburger, and Xiao-Ou Shu. "Systematic Review of Cancer Research Output From Africa, With Zambia as an Example." JCO Global Oncology, no. 7 (May 2021): 802–10. http://dx.doi.org/10.1200/go.21.00079.

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PURPOSE Cancer occurrence is increasing in Africa, although research has lagged. The objective of this review was to analyze cancer research outputs from Africa, with a particular focus on Zambia. METHODS We searched PubMed for published cancer-related articles from African countries. All articles reporting on cancer in Africa were considered. We conducted analyses to explore correlations between cancer research output and total population, gross domestic product, and new cancer cases recorded in 2020. For Zambia articles, we also analyzed cancer types and time trends. RESULTS A total of 48,487 cancer-related publications from Africa were identified, with nearly half coming from Egypt (13,372; 28%) and South Africa (9,393; 19%). Cancer research output correlated significantly with country population (Spearman's correlation coefficient 0.74; P < .001) and the number of new cancer cases recorded in 2020 (Spearman's correlation coefficient 0.77; P < .001). Standardized by population size, Western Sahara (0.576), Seychelles (0.244), Tunisia (0.239), South Africa (0.158), and Egypt (0.131) had the highest overall output per 1,000 population. A total of 244 publications were from Zambia; the most studied cancers were cervical (25%), Kaposi sarcoma (24%), and breast (10%). Although an increase in cancer research output from Zambia was noted, only 33% of publications were first or last authored by Zambians. The major limitation of this review is that the evaluation was based on a single electronic database, PubMed. CONCLUSION Cancer research output from Africa is very low, with many of the publications concentrated in a few countries. There is an urgent need to invest in both human resources and infrastructure to increase cancer research output from African countries, particularly in less populous countries.

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Vargas-Hernández, Víctor Manuel. "Risk Factors Associated with Breast Cancer." Journal of Hematology and Oncology Research 4, no. 1 (September 25, 2020): 1–5. http://dx.doi.org/10.14302/issn.2372-6601.jhor-20-3544.

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In Mexico, breast cancer is the second most common site of cancer in women and in most developed and emerging countries. Incidence rates have increased in many countries, although in some, mortality has remained stable with a slight reduction. There are geographical differences with high rates of breast cancer in North America, Northern Europe and Oceania, and lower rates in Central and South America, South and East Europe; in addition to emerging countries in Africa and Asia. Genetic and hereditary factors constitute less than 5% of breast cancer cases and other risk factors for breast cancer are related to the reproductive life of the woman. This work was carried out in order to determine if the risk factors considered classic are really associated with breast cancer in our sample of Mexican women studied.

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LaVigne, A., S. Grover, and S. Rayne. "Knowledge and Screening Practices of Breast and Cervical Cancer in Rural and Urban South Africa." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 46s. http://dx.doi.org/10.1200/jgo.18.38000.

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Background: The South African government has recently released cancer policies for breast and cervical cancer—the most common types and causes of cancer-related death in South African women. Increased mortality rates and advanced disease at presentation in comparison with developed countries suggests a need for greater awareness of risk factors, screening and preventative methods individualized for the population at risk. Aim: To characterize and compare the knowledge base and perceptions of women in urban and rural settings, we assessed these factors in two different cohorts in South Africa. Methods: A cross-sectional sample was taken in South Africa of women invited to participate in a survey regarding breast and cervical cancer knowledge, and awareness of risk factors, prevention and screening. Participants were approached in shopping malls and health facilities in urban Johannesburg in 2015 (“urban”) and semirural Bushbuckridge, 450 km northeast of Johannesburg (“rural”) in 2016. Results: 600 total women were surveyed, with 300 from each cohort. 83% of the urban cohort completed matriculation or higher, versus 60% of rural participants for whom high school was their highest level of education. Both groups demonstrated comparable levels of cancer awareness, and > 70% felt that cervical cancer is preventable. While the urban cohort was more knowledgeable about Pap smears (76% vs. 66%, P = 0.004), > 75% of both cohorts were willing to get one. Although both groups were largely unfamiliar with the role of HPV in cervical cancer, rural women were more aware of HIV (38% vs. 59%, P < 0.0001), smoking (43% vs. 62%, P < 0.0001) and parity (39% vs. 54%, P = 0.00019) as risk factors. Nevertheless, urban participants were more knowledgeable about breast self exams (71% vs. 59%, P = 0.001) and mammograms (62% vs. 42%, P < 0.0001), and more likely to undergo one (79% vs. 66%, P = 0.0002). Both groups identified family history and genetics as risk factors, but rural women appeared more aware of the roles of diet (30.67% vs. 39.93%, P = .011), oral contraceptives (17.33% vs. 34.77%, P < .0001), alcohol (26.67% vs. 52.15%, P < .0001) and lack of exercise (8.67% vs. 55.12%, P < .0001). Conclusion: Overall knowledge of breast and cervical cancer did not differ between both groups, despite varying levels of education and geographic setting. Women in the rural cohort demonstrated more awareness of several oncologic risk factors. Yet, the greater familiarity with and uptake of screening methods, especially for breast cancer, among women in the urban cohort may point to the benefits of proximity to health care infrastructure, such as tertiary care centers. This data supports a need for further implementation and distribution of cancer care services within cancer policies, to capitalize on increasingly sufficient levels of awareness among South African women.

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O’Neil, Daniel S., Wenlong Carl Chen, Oluwatosin Ayeni, Sarah Nietz, Ines Buccimazza, Urishka Singh, Sharon Čačala, et al. "Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures." Journal of Global Oncology, no. 5 (December 2019): 1–16. http://dx.doi.org/10.1200/jgo.19.00171.

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PURPOSE The quality of breast cancer care in sub-Saharan Africa contributes to the region’s dismal breast cancer mortality. ASCO has issued quality measures focusing on delivery of adjuvant chemotherapy, radiotherapy, and endocrine therapy. We applied these measures in five South African public hospitals and analyzed factors associated with care concordance. MATERIALS AND METHODS Among 1,736 women with breast cancer who were enrolled in the South African Breast Cancer and HIV Outcomes study over 24 months, we evaluated care using ASCO’s three measures. We also evaluated adjuvant chemotherapy receipt in 957 women with an indication. We used logistic regression to estimate associations between measure-concordant care and patient factors. RESULTS Of 235 women with hormone receptor–negative cancer, 173 (74%) began adjuvant chemotherapy within 120 days from diagnosis. Of 194 patients who received breast-conserving surgery, 73 (37%) began radiotherapy within 365 days from diagnosis. Of 999 women with hormone receptor–positive cancer, 719 (72%) initiated endocrine therapy within 365 days from diagnosis. Chemotherapy and radiotherapy measure-concordant care were more common among women residing < 20 km from the hospital (odds ratio [OR], 1.79; 95% CI, 1.32 to 2.44 and OR, 3.17; 95% CI, 1.57 to 6.42). Endocrine therapy measure-concordant care was more common among English-speaking women (OR, 2.12; 95% CI, 1.12 to 4.02). Participating hospitals varied in care concordance. HIV infection did not affect care quality. CONCLUSION More timely delivery of chemotherapy, radiotherapy, and endocrine therapy is needed in South Africa, particularly for women living > 20 km from the hospital or not speaking English. Focused quality improvement efforts could support that goal.

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Apffelstaedt, J., and K. Baatjes. "Breast cancer in emerging countries: The status of breast care in South Africa." European Journal of Cancer Supplements 6, no. 7 (April 2008): 167. http://dx.doi.org/10.1016/s1359-6349(08)70706-7.

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Roomaney, Rizwana, Ashraf Kagee, and Nina Knoll. "Received and perceived support subscales of the Berlin Social Support Scales in women diagnosed with breast cancer attending the breast clinic at Tygerberg hospital: structure and correlates." South African Journal of Psychology 50, no. 1 (February 25, 2019): 54–66. http://dx.doi.org/10.1177/0081246319831819.

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Research in the field of psycho-oncology in South Africa is increasing, and there is a need for validated measures that assess factors associated with cancer, such as social support. The Berlin Social Support Scales are a battery of instruments that measure various types and functions of social support. The measure was originally developed for use among adult cancer patients, and their partners but has also been used among other clinical populations and healthy adults. We investigated the psychometric properties of the English version of the perceived and received sub-scales, Berlin Social Support Scales. Our sample included South African women ( N = 201) who were diagnosed with breast cancer and receiving treatment at a public health care facility. We administered several measures, including a demographic questionnaire, the Berlin Social Support subscales, the Duke-UNC Functional Social Support Questionnaire, and The Functional Assessment of Cancer Therapy to participants. Validity and reliability analyses were conducted. Factor analysis resulted in the retention of 17 items that clustered on two factors, namely received support and perceived support. The 17-item version of the Berlin Social Support Scale demonstrated strong reliability and validity in the sample. The two subscales are quick to administer, easy to interpret, and are a reliable measure of social support among breast cancer patients in South Africa.

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Ruffieux, Yann, Mazvita Muchengeti, Matthias Egger, Orestis Efthimiou, Lina Bartels, Victor Olago, Maša Davidović, et al. "Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study." Clinical Infectious Diseases 73, no. 3 (February 2, 2021): e735-e744. http://dx.doi.org/10.1093/cid/ciab087.

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Abstract Background We analyzed associations between immunodeficiency and cancer incidence in a nationwide cohort of people living with human immunodeficiency virus (HIV; PLWH) in South Africa. Methods We used data from the South African HIV Cancer Match Study built on HIV-related laboratory measurements from the National Health Laboratory Services and cancer records from the National Cancer Registry. We evaluated associations between time-updated CD4 cell count and cancer incidence rates using Cox proportional hazards models. We reported adjusted hazard ratios (aHRs) over a grid of CD4 values and estimated the aHR per 100 CD4 cells/µL decrease. Results Of 3 532 266 PLWH, 15 078 developed cancer. The most common cancers were cervical cancer (4150 cases), Kaposi sarcoma (2262 cases), and non-Hodgkin lymphoma (1060 cases). The association between lower CD4 cell count and higher cancer incidence rates was strongest for conjunctival cancer (aHR per 100 CD4 cells/µL decrease: 1.46; 95% confidence interval [CI], 1.38–1.54), Kaposi sarcoma (aHR, 1.23; 95% CI, 1.20–1.26), and non-Hodgkin lymphoma (aHR, 1.18; 95% CI, 1.14–1.22). Among infection-unrelated cancers, lower CD4 cell counts were associated with higher incidence rates of esophageal cancer (aHR, 1.06; 95% CI, 1.00–1.11) but not breast, lung, or prostate cancer. Conclusions Lower CD4 cell counts were associated with an increased risk of developing various infection-related cancers among PLWH. Reducing HIV-induced immunodeficiency may be a potent cancer-prevention strategy among PLWH in sub-Saharan Africa, a region heavily burdened by cancers attributable to infections.

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Snyman, L. C. "Breast cancer mammography screening for low-risk women in South Africa." Southern African Journal of Gynaecological Oncology 2, no. 2 (January 2010): 69–70. http://dx.doi.org/10.1080/20742835.2010.11441164.

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Dickerson, Lindsay K., Anne F. Rositch, Susan Lucas, Lisa A. Mullen, and Susan C. Harvey. "An Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa." Journal of Global Oncology 4, Supplement 3 (October 2018): 14s. http://dx.doi.org/10.1200/jgo.18.10150.

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Purpose Breast cancer is the leading cause of cancer death in women worldwide, with a strikingly high mortality in low- and middle-income countries (LMICs) as a result of the scarcity of detection, diagnosis, and treatment. With mammography unavailable, ultrasound (US) offers a viable alternative. The literature reports successful training in various domains, but a curriculum focused on the breast is novel. We assessed the feasibility—knowledge acquisition, perceived utility, and self-efficacy—of a breast US training program for the detection of breast cancer by nonphysician providers. Methods Training was implemented for 12 providers, including professional nurses, nursing assistants, and lay counselors, at Hlokomela clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey (n = 12) that characterized providers’ initial attitudes toward early detection and a pretest (n = 12) that determined immediate retention of knowledge and areas for focused training. All providers received hands-on training with nurses as models. Five providers trained with patients. A post-test (n = 12) assessed overall knowledge retention and acquisition, and a postsurvey (n = 10) gauged program acceptance and provider self-efficacy with breast US. Results Pretest to post-test averages improved by 68% overall and in four competencies—foundational knowledge, descriptive categories, benign versus malignant, and lesion identification. On the postsurvey, providers expressed the belief that US could significantly affect breast cancer detection (9.1/10), treatment (7.9/10), and survival (8.7/10) in their communities and endorsed moderate confidence in their scanning (6.3/10) and interpreting abilities (5.6/10). Conclusion There is a pressing need for a paradigm shift in breast cancer care in LMICs, with early detection critical to improving outcomes. Our research supports the feasibility of breast US training as part of a breast education program in LMICs. Pretest and post-test results and observed proficiency indicate that training nonphysician providers is achievable. Postsurvey responses indicate program acceptance, provider self-efficacy with US, and community-based ownership of a breast cancer screening and awareness initiative. Follow-up work that is focused on quality improvement and sustainability is ongoing. Future work may show that breast US is viable for early detection when mammography is unavailable. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Susan C. Harvey Consulting or Advisory Role: IBM Watson, Hologic Inc Research Funding: IBM Watson

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Mbeje, Noluthando P., Themba G. Ginindza, and Nkosana Jafta. "Establishing and Evaluating Cancer Surveillance System in KwaZulu-Natal, South Africa." Cancer Informatics 20 (January 2021): 117693512110299. http://dx.doi.org/10.1177/11769351211029967.

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Background: The increasing cancer burden remains a public health challenge. Quality and accurate population data is important to improve cancer control, screening, and treatment programmes for the sub-Saharan Africa region. Aim: The aim of this study was to establish hospital-based cancer surveillance system, thereby reporting the burden that cancer diagnosis and treatment place on 3 hospitals – an approach of health systems strengthening. Methods: A hospital-based cancer surveillance was established in 3 public health facilities that provide oncology services in KwaZulu-Natal. An active method was used for finding cancer cases. The cancer surveillance database was evaluated according to the criteria recommended for cancer registries. Analyses of data included descriptive and crude incidence rates. Results: A total of 2307 newly diagnosed cancer cases were reported in 2018, with a majority from Inkosi Albert Luthuli Central hospital (65.3%), followed by Greys hospital (30.8%) and then Addington hospital (3.94%). Most of the cancer cases were from the 2 major urban areas of the province (eThekwini and uMgungundlovu district). The most commonly diagnosed cancers from all combined 3 facilities for both sexes were breast, cervix, colorectal, Kaposi Sarcoma, and lung. Approximately half of the cancer cases had no staging, and 12.8% of the cases were diagnosed at stage 4. The mostly prescribed treatments for the patients were radiotherapy and chemotherapy. Conclusions: Based on our hospital-based surveillance, cancer burden is high in the 3 facilities. Strengthening cancer screening and diagnostic policies and procedures that will allow expansion of accurate cancer surveillance system is essential in KwaZulu-Natal and South Africa as a whole.

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Matatiele, PR, and WMJ Van den Heever. "Breast cancer profiles of women presenting with newly diagnosed breast cancer at Universitas Hospital (Bloemfontein, South Africa)." South African Family Practice 50, no. 6 (November 2008): 48–49. http://dx.doi.org/10.1080/20786204.2008.10873786.

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Langenhoven, Lizanne, Pieter Barnardt, Alfred I. Neugut, and Judith S. Jacobson. "Phenotype and Treatment of Breast Cancer in HIV-Positive and -Negative Women in Cape Town, South Africa." Journal of Global Oncology 2, no. 5 (October 2016): 284–91. http://dx.doi.org/10.1200/jgo.2015.002451.

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Purpose An estimated 5.9 million people in South Africa are infected with HIV. Because antiretroviral therapy has made infection with HIV a treatable, chronic condition, HIV-infected individuals are now surviving to middle and older age. We investigated the implications of HIV status for breast cancer in South Africa. Methods We compared clinical and demographic characteristics of women newly diagnosed with a first primary breast cancer at Tygerberg Hospital, Cape Town, South Africa, from January 2010 to December 2011 by HIV status. We then compared HIV-positive patients with HIV-negative controls, matched 2:1 on age and ethnicity, with respect to chemotherapy regimens, toxicities, completion of systemic chemotherapy, and changes in CD4 cell count. Results Of 586 women with breast cancer, 31 (5.3%) were HIV positive, 420 (71.7%) were HIV negative, and 135 (23%) were untested for HIV. Women with HIV were younger than other women (P < .001). The groups did not differ in regard to stage at presentation, histologic subtype, tumor grade, nodal involvement, or hormone receptor positivity. More than 84% of patients who initiated systemic chemotherapy, regardless of HIV status, completed it without serious toxicity. Among HIV-positive patients receiving chemotherapy, the mean baseline CD4 cell count was 477 cells/µL (standard deviation, 160 cells/µL), and the mean nadir was 333 cells/µL (standard deviation, 166 cells/µL). Conclusion HIV-infected women were younger at breast cancer diagnosis than HIV-negative women but otherwise similar in phenotype and completion of chemotherapy. Longer term follow-up is needed to evaluate the effects of HIV, antiretroviral therapy, and chemotherapy on the survival and quality of life of patients with breast cancer.

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Wadler, Brianna M., Christine M. Judge, Marianne Prout, Jennifer D. Allen, and Alan C. Geller. "Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review." Journal of Oncology 2011 (2011): 1–8. http://dx.doi.org/10.1155/2011/150423.

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Breast cancer is a growing concern in low- and middle-income countries (LMCs). We explore community health worker (CHW) programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness about breast cancer through education, women are more likely to undergo screening. Many more women can be screened resulting in earlier-stage disease if CHWs are trained to perform clinical breast exams. As patient navigators, CHWs can guide women through the screening and treatment process. It is suggested that these roles be combined within existing CHW programs to maximize resources and improve breast cancer outcomes in LMCs.

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Rubin, Grace, Sarah Rayne, Naomi Lince-Deroche, Cheryl Hendrickson, Kate Shearer, Faith Moyo, Pamela Michelow, Carol Benn, and Cindy Finhaber. "Characterization and costs of breast conditions at an open access breast clinic in South Africa." Journal of Clinical Oncology 36, no. 15_suppl (May 20, 2018): e13570-e13570. http://dx.doi.org/10.1200/jco.2018.36.15_suppl.e13570.

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Dickerson, Lindsay K., Anne F. Rositch, Susan Lucas, and Susan C. Harvey. "Pilot Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa." Journal of Global Oncology 3, no. 5 (October 2017): 502–8. http://dx.doi.org/10.1200/jgo.2016.008086.

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Purpose Breast cancer is the leading cause of cancer death in women worldwide, with high mortality in low- and middle-income countries because of a lack of detection, diagnosis, and treatment. With mammography unavailable, ultrasound offers an alternative for downstaging. The literature reports successful training in various domains, but a focus on the breast is novel. We assessed the feasibility (knowledge acquisition, perceived usefulness, and self-efficacy) of breast ultrasound training for nonphysician providers. Methods Training was implemented for 12 providers at Hlokomela Clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey and test (n = 12). All providers received hands-on training with nurses as models; five providers trained with patients. A post-test (n = 12) assessed knowledge acquisition and a postsurvey (n = 10) assessed perceived program usefulness and provider self-efficacy. Results The pre- to post-test averages improved by 68% in total and in four competencies (foundational knowledge, descriptive categories, benign v malignant, and lesion identification). On the postsurvey, providers expressed that ultrasound could significantly influence breast cancer detection (9.1 out of 10), treatment (7.9 out of 10), and survival (8.7 out of 10) in their community and endorsed moderate confidence in their scanning (6.3 out of 10) and interpreting abilities (5.6 out of 10). Conclusion Our research supports the feasibility of breast ultrasound training as part of a breast education program in low- and middle-income countries. Pre- and post-test results and observed proficiency indicate that training nonphysician providers is achievable; postsurvey responses indicate program acceptance, community-based ownership, and provider self-efficacy with ultrasound. Future work may show that breast ultrasound is viable for early detection where mammography is unavailable.

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Cubasch, Herbert, Maureen Joffe, Rachel Hanisch, Joachim Schuz, Alfred I. Neugut, Alan Karstaedt, Nadine Broeze, Eunice van den Berg, Valerie McCormack, and Judith S. Jacobson. "Breast cancer characteristics and HIV among 1,092 women in Soweto, South Africa." Breast Cancer Research and Treatment 140, no. 1 (June 26, 2013): 177–86. http://dx.doi.org/10.1007/s10549-013-2606-y.

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Schoeman, Mardelle, Justus P. Apffelstaedt, Karin Baatjes, and Michael Urban. "Implementation of a breast cancer genetic service in South Africa – lessons learned." South African Medical Journal 103, no. 8 (June 25, 2013): 529. http://dx.doi.org/10.7196/samj.6814.

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Moodley, J., F. M. Walter, S. E. Scott, and A. M. Mwaka. "Towards timely diagnosis of symptomatic breast and cervical cancer in South Africa." South African Medical Journal 108, no. 10 (October 2, 2018): 803. http://dx.doi.org/10.7196/samj.2018.v108i10.13478.

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Kramer, Nicky, Jo Ramjith, and Delva Shamley. "Prevalence of shoulder morbidity after treatment for breast Cancer in South Africa." Supportive Care in Cancer 27, no. 7 (November 19, 2018): 2591–98. http://dx.doi.org/10.1007/s00520-018-4540-3.

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Rayne, Sarah, Kathryn Schnippel, Cynthia Firnhaber, Kathryne Wright, Deirdre Kruger, and Carol-Ann Benn. "Fear of Treatments Surpasses Demographic and Socioeconomic Factors in Affecting Patients With Breast Cancer in Urban South Africa." Journal of Global Oncology 3, no. 2 (April 2017): 125–34. http://dx.doi.org/10.1200/jgo.2015.002691.

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Purpose Breast cancer is the most common cause of cancer in women in South Africa, and often patients present late. There is little understanding of the psychosocial stresses affecting women with breast cancer in Africa. Methods A questionnaire was distributed to 263 patients with breast cancer at two sites (one government and one private facility) in Johannesburg. Self-reported levels of fear were recorded on summative scales and their relationship to demographic variables assessed through univariable and multivariable modified Poisson regression. Results Fears related to treatments and prognosis, particularly radiation, loss of hair, and loss of breast, were far stronger than those related to socioeconomic barriers. Relative risk (RR) of most fears was higher in women younger than age 40 years, including treatment affordability (RR, 1.80; 95% CI, 1.26 to 2.56), hair loss (RR, 1.48; 95% CI, 1.12 to 2.95), and surgery (RR, 1.31; 95% CI, 1.02 to 1.68). Difficulty taking time off work predicted fear of job loss (RR, 2.59; 95% CI, 1.59 to 4.21) and missing appointments because of transport (RR, 2.46; 95% CI, 1.52 to 3.96) or family commitments (RR, 2.46; 95% CI, 1.52 to 3.96). Women with dependents and black women were more afraid of dying (RR, 1.73; 95% CI, 1.03 to 2.90; and RR, 1.79; 95% CI, 1.33 to 2.24, respectively); however, socioeconomic status in this sample was a strong confounder of race and explained most of the racial differences in levels of fear. Conclusion The most significant fears around breast cancer were related to treatment modalities and adverse effects rather than transport, financial, or work concerns. Young age and job insecurity were predictive of increased fears. Education about treatments has a key role to play in improving access to breast cancer care in South Africa.

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Kriel, Inge, Kyara Bergstrom, and Carol Benn. "An assessment of supplement use in breast cancer patients from a single unit in South Africa." Journal of Clinical Oncology 36, no. 7_suppl (March 1, 2018): 89. http://dx.doi.org/10.1200/jco.2018.36.7_suppl.89.

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89 Background: Breast cancer patients are particularly susceptible to marketing strategies employed to encourage the use of natural supplements and natural therapies. Supplements/natural therapies are freely available from various sources, including online commercial sites, therefore making them readily accessible and poorly regulated. Methods: An anonymous questionnaire on supplement use was distributed to patients diagnosed with breast cancer. Fifty-one questionnaires were completed and data was collected into a REDCapTM based database and subsequently analysed. Results: Thirty-two patients (62.7%) were using supplements prior to their diagnosis. Thirty-two (62.7%) patients did not think supplements had harmful side effects and thirty (58.8%) patients did not think they could interfere with their cancer treatment. Thirty-five patients (68.6%) would however stop their supplements if they were informed of possible interactions. Thirty-eight (74.5%) patients would prefer if their doctor informed them of potential interactions and side effects. Conclusions: Supplement use is common in breast cancer patients. The majority of patients did not believe that supplements could interfere with conventional breast cancer treatments, but the majority of patients are willing to stop the supplements if they are informed of potential interactions. Patients would prefer their doctor to inform them on supplement use. A further study is warranted to assess doctors’ knowledge around supplement side-effects and interactions.

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Cubasch, Herbert, Maureen Joffe, Paul Ruff, Donald Dietz, Evan Rosenbaum, Nivashni Murugan, Ming Tsai Chih, et al. "Breast conservation surgery versus total mastectomy among women with localized breast cancer in Soweto, South Africa." PLOS ONE 12, no. 8 (August 10, 2017): e0182125. http://dx.doi.org/10.1371/journal.pone.0182125.

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Zwane, Duduzile. "“Our Beauty Is in Our Breasts”: A Culture-Centered Approach to Understanding Cancer Perceptions in Kwa Zulu Natal, South Africa." Qualitative Health Research 31, no. 1 (September 30, 2020): 148–59. http://dx.doi.org/10.1177/1049732320960417.

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Breast cancer is an incapacitating physical illness. It was once reported predominantly by patients in developed countries. With the advent of globalization, it is increasingly becoming a major health concern in developing countries such as South Africa. Breast cancer researchers have continuously advocated for original studies that address this condition from a sociocultural perspective. Consequently, in this article I examine the perceptions of breast cancer patients from underprivileged parts of Kwa Zulu Natal (KZN). Thirty semi-structured interviews were conducted with Zulu women at a tertiary hospital in the region. A culture-centered approach was utilized to gauge their perceptions of life as breast cancer patients within the conservative Zulu community. The findings revealed that this ailment is generally misunderstood, which has adverse implications for the patients. Furthermore, there is a dire need for breast cancer communication interventions that can acquaint the Zulu community with this condition.

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Joffe, Maureen, Oluwatosin Ayeni, Shane Anthony Norris, Valerie Ann McCormack, Paul Ruff, Ishani Das, Alfred I. Neugut, Judith S. Jacobson, and Herbert Cubasch. "Barriers to early presentation of breast cancer among women in Soweto, South Africa." PLOS ONE 13, no. 2 (February 2, 2018): e0192071. http://dx.doi.org/10.1371/journal.pone.0192071.

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Hadley, Megan E., Lisa A. Mullen, Lindsay Dickerson, and Susan C. Harvey. "Assessment and Improvement Strategies for a Breast Cancer Early Detection Program in Rural South Africa." Journal of Global Oncology 4, Supplement 3 (October 2018): 16s. http://dx.doi.org/10.1200/jgo.18.10180.

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Purpose More than one half of breast cancer deaths occur in low- and middle-income countries, where survival rates are 60% at best. Appropriate programs that improve detection, diagnosis, and treatment in low- and middle-income countries are essential to improving breast cancer outcomes. The sustainability of such programs requires ongoing efforts, yet there remains a lack of literature on follow-up to assure long-term program success. Our study aimed to understand what needs developed in the year after the implementation of an early detection program and to evaluate potential solutions. Methods A WHO-endorsed RAD-AID Radiology Readiness Assessment evaluated clinic resources. In addition, in 5 weeks of observation we identified resource deficiencies and reviewed existing documentation methods. On the basis of stakeholders’ input and the Breast Imaging Reporting and Data System, we developed new documentation systems. Training was followed by a survey that assessed feasibility and provider acceptance. Results Resource limitations included a lack of computers, unpredictable electrical supply, and inconsistent Internet. Assessment revealed incomplete documentation of breast clinical examinations and history, breast lesions, and follow-up. In addition, limitations negatively impacted communication between providers. Three solutions were developed: a paper patient history form, a paper clinical findings form, and a computerized patient-tracking database that was compliant with the Breast Imaging Reporting and Data System. Three nurses, three nursing assistants, and one counselor completed the survey. Seventy-one percent (five of seven respondents) indicated positive or very positive general attitudes. One hundred percent of respondents agreed or strongly agreed to the following statement: the documentation system is easy, useful, and improves overall quality of care, follow-up, decision making, access to clinical information, and communication between clinicians and patients. Five of seven providers reported that the system increased visit time, but three of these five felt that the process was valuable. Conclusion Implementing a breast cancer early detection program in resource-limited regions is challenging and continued assessment is essential. As a result of identified needs, we developed a documentation system that was broadly accepted. Potential future steps should focus on increasing efficiency, evaluating provider attitudes on a long-term basis, and clinical impact. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Susan C. Harvey Honoraria: Hologic Inc, IBM Watson Imaging Consulting or Advisory Role: IBM Watson, Hologic Inc Research Funding: IBM Watson

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Hadley, Megan, Lisa A. Mullen, Lindsay Dickerson, and Susan C. Harvey. "Assessment and Improvement Strategies for a Breast Cancer Early Detection Program in Rural South Africa." Journal of Global Oncology, no. 4 (December 2018): 1–12. http://dx.doi.org/10.1200/jgo.18.00015.

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Purpose To assess and develop solutions for an ultrasound-based breast cancer early detection program in rural South Africa 1 year after implementation. Methods A WHO-endorsed RAD-AID Radiology Readiness Assessment was used to evaluate clinic resources. In addition, 5 weeks of observation identified resource deficiencies and reviewed existing documentation methods. On the basis of stakeholders’ input and the BI-RADS, we developed new documentation systems. Training was followed by a survey that assessed feasibility and provider acceptance. Results Resource limitations included lack of computers, unpredictable electrical supply, and inconsistent Internet. The assessment revealed incomplete documentation of breast clinical examinations and history, breast lesions, and follow-up. Furthermore, limitations negatively affected communication among providers. Three solutions were developed: a paper patient history form, a paper clinical findings form, and a computerized patient-tracking data base compliant with BI-RADS. Three nurses, three nursing assistants, and one counselor completed the survey. Seventy-one percent indicated positive general attitudes, and 100% agreed that the documentation system is easy and useful and improves overall quality of care, follow-up, decision making; access to clinical information; and communication between clinicians and patients. Five of the seven providers reported that the system increased visit time, but three of those five believed that the process was valuable. Conclusion Implementation of a breast cancer early detection program in resource-limited regions is challenging, and continual assessment is essential. As a result of identified needs, we developed a documentation system that was broadly accepted. Future steps should focus on increasing efficiency, evaluation of provider attitudes long term, and clinical effect.

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Van Oers, HM. "Exercise effects on mood in breast cancer patients." South African Journal of Sports Medicine 25, no. 2 (June 15, 2013): 55. http://dx.doi.org/10.17159/2078-516x/2013/v25i2a381.

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Breast cancer is one of the most common cancers worldwide, and statistics reveal that the number of women diagnosed with breast cancer in South Africa is increasing. As such, medical practitioners will treat an increasing number of breast cancer patients. Although increasingly effective treatments improve patient survival intervals, a significant number of patients experience psychological distress, at the time of diagnosis and sometimes well beyond the start of treatment. This can be attributed to the disease itself and to treatment side-effects. Historically, patients experiencing such distress have been treated with pharmacotherapy or have been referred for psychotherapeutic intervention. Although it is well known that physical exercise is beneficial to physical health, only recently, and comparatively, has the effect of exercise been recognised as beneficial to psychological well-being. Cancer patients are often advised to reduce physical activity to avoid cancer-related fatigue. Paradoxically, recent research shows that physical exercise, of the type and intensity appropriate for the ability of each patient, can in fact play a significant role in improving mood and aiding physical recovery. This opens up a valuable additional resource to augment patients’ quality of life, both physically and psychologically. One precaution stands vitally important, however: the prescribed exercise regimen must be tailored to the physical capabilities of the patient.

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Van Oers, HM. "Exercise effects on mood in breast cancer patients." South African Journal of Sports Medicine 25, no. 2 (July 2, 2013): 55. http://dx.doi.org/10.17159/2413-3108/2013/v25i2a381.

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Breast cancer is one of the most common cancers worldwide, and statistics reveal that the number of women diagnosed with breast cancer in South Africa is increasing. As such, medical practitioners will treat an increasing number of breast cancer patients. Although increasingly effective treatments improve patient survival intervals, a significant number of patients experience psychological distress, at the time of diagnosis and sometimes well beyond the start of treatment. This can be attributed to the disease itself and to treatment side-effects. Historically, patients experiencing such distress have been treated with pharmacotherapy or have been referred for psychotherapeutic intervention. Although it is well known that physical exercise is beneficial to physical health, only recently, and comparatively, has the effect of exercise been recognised as beneficial to psychological well-being. Cancer patients are often advised to reduce physical activity to avoid cancer-related fatigue. Paradoxically, recent research shows that physical exercise, of the type and intensity appropriate for the ability of each patient, can in fact play a significant role in improving mood and aiding physical recovery. This opens up a valuable additional resource to augment patients’ quality of life, both physically and psychologically. One precaution stands vitally important, however: the prescribed exercise regimen must be tailored to the physical capabilities of the patient.

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Mzezewa, Salathiel Zhou, Musa Setati, Thendo Netshiongolwe, and Vusani Sinoamadi. "Prevalence of breast cancer in reduction mammoplasty specimens, in women of African origin: preliminary histology results at Mankweng and Polokwane hospitals." Journal of Medical Research and Health Sciences 3, no. 10 (October 10, 2020): 1109–13. http://dx.doi.org/10.15520/jmrhs.v3i10.264.

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Abstract Introduction. We report the first study on the prevalence of breast cancer in reduction mammoplasty specimens conducted in Limpopo province, South Africa. The prevalence of breast cancer is relatively low among pre-menopausal African women. Worldwide prevalence has been reported to range between 0.1% and 4.5%. Patients requesting reduction mammoplasty fear that their breast enlargement may be caused by the disease. Reduction mammoplasty is a common operation performed by plastic and reconstructive surgeons globally, but is an uncommon operation in Limpopo. Aims and objectives. To determine the prevalence of breast cancer in reduction mammoplasty specimens and to record the pertinent characteristics. Method. A prospective study of 104 female patients requesting reduction mammoplasty from 2007–2014 at Polokwane and Mankweng hospitals. The outcome measures were weight of specimens and histological investigation for breast carcinoma, body mass index and jugular–nipple distances. Results. All patients were of African origin whose median age was 32.4 (16–53) years, and median weight of excised tissue was 3.4 (1.45–6.2) kg. The median weight of patients was 77 (63–92) kg. The median BMI was 34.5 (29.1–39.9) kg/m2. The median jugular–nipple distance was 39 (25–51) cm on the right and 41 (29–53) cm on the left breast. Histological investigation revealed normal breast tissue in 57 cases, fibroadenosis in 25 cases, and duct hyperplasia in 22 cases. Conclusion. Breast cancer was not detected. The study population was relatively young at a mean age of 32.4 (16–53) years, without personal nor family history of breast cancer.

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Lasebikan, N., N. Iloanusi, T. Onyeka, C. Ilo, K. Nwankwo, V. Okwor, N. Chigbo, et al. "Tailoring Therapies: Improving the Outcome of Breast Cancer in a Comprehensive Cancer Center in West Africa—The University of Nigeria Teaching Hospital Experience." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 163s. http://dx.doi.org/10.1200/jgo.18.73100.

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Background and context: Early detection and improved treatments are associated with a reduction in breast cancer mortality and morbidity. UNTH is a leading comprehensive cancer center in Nigeria with referrals from the entire southeast and south south regions. Our goal is to offer high quality comprehensive cancer care services across the cancer care continuum from public health awareness campaigns and provision of screening services all the way to palliative care and survivorship. This is the first attempt by any institution in the country to standardize and harmonize available treatment options for breast cancer. Aim: To optimize, standardize and harmonize treatment options and management strategies for breast cancer using a multidisciplinary approach by developing guidelines adapted to our peculiar infrastructure and health system. Strategy/Tactics: The practice guideline was specifically developed for UNTH using a multidisciplinary approach and taking into consideration circumstances peculiar to UNTH, including the following: UNTH's specific patient population; UNTH's services and structure; and UNTH's clinical information. Program/Policy process: The process used recognized methods that are robust, objective, scientifically valid, consistent and adaptable to UNTH and engaged all identified multisectoral and multidisciplinary stakeholders involved in the care of patients with breast cancer. Outcomes: We reviewed substantial evidence on documented and proven strategies for community screening and prevention, less expensive and only marginally less effective diagnostic tools, locoregional and systemic therapies for the management of breast cancer. The team also recommended all patients receive psycho-oncology support through a dedicated team and through the breast cancer support group. It was agreed that palliative care be incorporated within the first 8 weeks of commencing treatment in line with the current ASCO guidelines and receive consultation from the exercise immunology unit. What was learned: Institutionalized care offers better management strategies and standardized treatment in line with best global practices of care for patients with breast cancer across the cancer care continuum which will ultimately translate to better treatment outcomes.

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Dickens, Caroline, Ruth M. Pfeiffer, William F. Anderson, Raquel Duarte, Patricia Kellett, Joachim Schüz, Danuta Kielkowski, and Valerie A. McCormack. "Investigation of breast cancer sub-populations in black and white women in South Africa." Breast Cancer Research and Treatment 160, no. 3 (October 18, 2016): 531–37. http://dx.doi.org/10.1007/s10549-016-4019-1.

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Rayne, Sarah, Kathryn Schnippel, Carol Benn, Deirdre Kruger, Kathryne Wright, and Cynthia Firnhaber. "The Effect of Access to Information on Beliefs Surrounding Breast Cancer in South Africa." Journal of Cancer Education 33, no. 4 (May 24, 2017): 806–13. http://dx.doi.org/10.1007/s13187-017-1234-3.

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Nietz, Sarah, Paul Ruff, Wenlong Carl Chen, Daniel S. O’Neil, and Shane A. Norris. "Quality indicators for the diagnosis and surgical management of breast cancer in South Africa." Breast 54 (December 2020): 187–96. http://dx.doi.org/10.1016/j.breast.2020.09.012.

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Eyigör, Sibel. "Comments on “Prevalence of shoulder morbidity after treatment for breast Cancer in South Africa”." Supportive Care in Cancer 28, no. 3 (July 16, 2019): 959–60. http://dx.doi.org/10.1007/s00520-019-04990-z.

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Kamaraju, Sailaja, Jeffrey Drope, Rengaswamy Sankaranarayanan, and Surendra Shastri. "Cancer Prevention in Low-Resource Countries: An Overview of the Opportunity." American Society of Clinical Oncology Educational Book, no. 40 (May 2020): 72–83. http://dx.doi.org/10.1200/edbk_280625.

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Rising trends in the incidence of cancer in low- and middle-income countries (LMICs) add to the existing challenges with communicable and noncommunicable diseases. While breast and colorectal cancer incidence rates are increasing in LMICs, the incidence of cervical cancer shows a mixed trend, with rising incidence rates in China and sub-Saharan Africa and declining trends in the Indian subcontinent and South America. The increasing frequencies of unhealthy lifestyles, notably less physical activity, obesity, tobacco use, and alcohol consumption are causing a threat to health care in LMICs. Also, poorly developed health systems tend to have inadequate resources to implement early detection and adequate basic treatment. Inequalities in social determinants of health, lack of awareness of cancer and preventive care, lack of efficient referral pathways and patient navigation, and nonexistent or inadequate health care funding can lead to advanced disease presentation at diagnosis. This article provides an overview of opportunities to address cancer control in LMICs, with a focus on tobacco control, vaccination for cervical cancer, novel tools to assist with early detection, and screening for breast and other cancers.

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Donninger, Howard, David M. Dent, and M. Iqbal Parker. "Infrequent and Unusual p53 Mutations in Breast Cancers in South Africa." Genome Letters 1, no. 4 (December 1, 2002): 157–64. http://dx.doi.org/10.1166/gl.2002.018.

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Langa, Bridget C., Márcia M. C. Oliveira, Silma R. F. Pereira, Kamil Lupicki, Catalin Marian, Dhirendra Govender, Eugenio Panieri, et al. "Copy Number Analysis of the DLX4 and ERBB2 Genes in South African Breast Cancer Patients." Cytogenetic and Genome Research 146, no. 3 (2015): 195–203. http://dx.doi.org/10.1159/000439155.

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Breast cancer is one of the main causes of cancer death among South African women. Although several risk factors can be attributed to the observed high mortality rate, the biology of the tumors is not extensively investigated. Copy number gain of the DLX4 homeobox gene has been observed in breast cancer in association with poor prognosis and specific racial groups. Therefore, we aimed to assess the copy number and prognostic role of DLX4 in breast cancer from South African patients. Due to the co-location of ERBB2 and DLX4 in the 17q21 region, its copy number was also evaluated. Our results in the analysis of 66 cases demonstrated copy number gains of DLX4 and ERBB2 in 24.1 and 29.7% of the cases, respectively. Linear regression analysis showed no dependency between the copy number alterations in these genes. Although not significant, patients with DLX4 and ERBB2 gains presented a higher frequency of advanced-grade tumors. In addition, copy number alterations of these genes were not significantly differently observed in the 3 main racial groups of the Western Cape population: Colored, White, and Black. These findings indicate that gains of DLX4 and ERBB2 occur in South African breast cancer patients irrespectively of their race and factors known to influence prognosis.

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Peltzer, Karl, and Nancy Phaswana-Mafuya. "Breast and Cervical Cancer Screening and Associated Factors among Older Adult Women in South Africa." Asian Pacific Journal of Cancer Prevention 15, no. 6 (March 30, 2014): 2473–76. http://dx.doi.org/10.7314/apjcp.2014.15.6.2473.

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Matatiele, PR, and WMJ Van den Heever. "Evaluation of breast cancer awareness among women presenting with newly diagnosed breast disease at Universitas Hospital (Bloemfontein, South Africa)." South African Family Practice 50, no. 4 (July 2008): 69–69. http://dx.doi.org/10.1080/20786204.2008.10873745.

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Rayne, Sarah, Kathryn Schnippel, John Thomson, Joanna Reid, and Carol Benn. "Male Breast Cancer Has Limited Effect on Survivor’s Perceptions of Their Own Masculinity." American Journal of Men's Health 11, no. 2 (June 23, 2016): 246–52. http://dx.doi.org/10.1177/1557988316631512.

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The purpose of the current study was to describe male breast cancer in Johannesburg, South Africa, and assess whether male breast cancer patients’ perception of their own masculinity was affected by having a cancer commonly seen in women. A retrospective file review was carried out at two hospitals, one private and one government, of male breast cancer patients from 2007 to 2012 followed by a telephone survey of patients identified during review. Of approximately 3,000 breast cancer patients seen in the 5 years reviewed, 23 cases of male breast cancer were identified. Most were diagnosed with invasive ductal carcinoma ( n = 19, 83%). Stage at presentation was from stages 0 to 3 (Stage 0 [ n = 2, 9%], Stage 1 [ n = 3, 13%], Stage 2 [ n = 12, 52%], Stage 3 [ n = 6, 26%]) and no patients were metastatic at presentation. The telephonic survey was completed by 18 patients (78%). Nearly all ( n = 17/18) shared their diagnosis with family and close friends. Two thirds of patients delayed presentation and government hospital patients were more likely to present later than private sector hospital patients. Although most male breast cancer patients sampled did not perceive the breast cancer diagnosis as affecting their masculinity, Black men and those treated in government hospitals were less likely to be aware of male breast cancer, and were more likely to have their perception of their own masculinity affected.

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Journal articles on the topic 'Breast cancer south africa'

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