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1
Agenbag, Gloudi. "Molecular genetic analysis of familial breast cancer in South Africa". Thesis, Link to the online version, 2005. http://hdl.handle.net/10019/953.
Testo completo
2
Kramer, Nicole. "Prevalence of shoulder morbidity after treatment for breast cancer in South Africa". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/27973.
Testo completoAbstract (sommario):
Introduction: Breast cancer is the most frequently diagnosed cancer and leading cause of cancer death among women and represents a considerable public health burden in South Africa and other low-middle income countries. Breast cancer management comprises single or combination treatment including surgery, radiotherapy and chemotherapy. Short and long-term complications of these treatments include shoulder morbidities such as pain, decreased range of motion, tightness, weakness, pain, numbness and lymphoedema, and may be present for up to 6 years post-surgery. An understanding of baseline demographic and clinical risk factors can guide rehabilitation and management strategies for high risk patients. Materials and Methods: This study was a cross-sectional analysis of the prevalence of shoulder pain and dysfunction in women attending their post-treatment annual follow up visit for unilateral breast carcinoma. The aim of this study was to quantify the burden of shoulder pain and disability in a tertiary academic hospital in Cape Town, South Africa, and identify potential risk factors for the development of shoulder morbidity. The primary objective of this study was to determine the prevalence of shoulder morbidity and the secondary objective was to evaluate associations between shoulder morbidity and risk factors such as treatment protocol or baseline demographics. Results: The majority of patients were of mixed ancestry, had their left side affected, received ALND and had undergone Modified Radical Mastectomy. The mean age was 60 years with a mean follow-up since surgery of 6 years. Three-quarters of patients reported a presence of pain or disability; 9% experienced severe pain and disability. Multivariable ordinal logistic regression analysis identified race, side, axillary surgery, chemotherapy and age as significant predictors of pain, and chemotherapy a significant predictor of disability. Discussion: The substantial burden of shoulder morbidity in this population represents a significant public health burden. The use of identified clinical and demographic characteristics may guide in the development of survivorship programmes incorporating surveillance and management of these high risk patients.
3
Daries, Valdiela. "The profile of breast cancer among patients attending a Breast Clinic in Cape Town, South Africa". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/6033.
Testo completoAbstract (sommario):
Includes abstract.Includes bibliographical references.
Breast cancer is the leading cancer among women in South Africa (SA). Studies conducted in developing countries have shown that the majority of women present with advanced stage breast cancer at diagnosis. There is a gap in terms of recent data on the profile of breast cancer patients in SA. The purpose of the study was to obtain recent data with regards to the sociodemographic, clinical and risk factor profile of breast cancer in patients who presented at a Breast Clinic linked to a tertiary public hospital in the Western Cape in order to underpin the development of strategies for earlier detection and diagnosis of breast cancer. A cross-sectional descriptive medical record review was conducted. The studypopulation included all newly diagnosed patients with histological or cytological confirmedbreast cancer who presented at the Breast Clinic during the period 01 January 2009 to 31December 2010. All patients with a previous diagnosis of breast cancer were excluded. Data onthe socio-demographic, clinical and risk factor profile of breast cancer patients were collectedusing a standardised data capture sheet. Data was entered using Epidata version 3.1 and analysedusing Stata Statistical package version 12.After calculation of initial descriptive analysis for the whole sample, male subjects wereexcluded and further analysis was restricted to 585 female subjects. Stage at presentation wascategorised as “early stage” (stage 0, I, IIA, IIB) and “late stage” (stage IIIA, IIIB, IIIC, IV). Crude associations of potential predictors with stage at presentation were tested using Wilcoxon rank-sum tests for medians and Chi-square tests and Fischer Exact tests for proportions. Logistic regression was used to create a model with stage at presentation as dependent variable. Age and racial group were introduced in the model as possible confounders. Based on literature findings other variables present in the dataset were considered as potential predictors of stage at presentation (namely place of residence, employment status, medical aid status, family history of breast cancer, menopausal status, parity, having ever smoked or used alcohol, clinical signs of breast cancer as well as duration of symptoms) and introduced in the model if their bivariate association with the outcome (adjusted for age and race) was statistically significant. A significance level of p <; 0.15 was used. The only variable showing a significant association according to this criterion was the ordinal variable duration of symptoms. The final logistic regression model, therefore, included stage at presentation as the dependent variable and age, racial group and symptom duration as predictors.
4
Scullard, Nicole. "Subjective lived experiences of women with early stage breast cancer in Cape Town". University of the Western Cape, 2015. http://hdl.handle.net/11394/5081.
Testo completoAbstract (sommario):
Magister Artium - MABreast cancer is a common cause of death among women worldwide. It has long been recognized as a major public health burden in high-income countries, however, the majority of cases are said to occur in low and middle-income countries, such as in South Africa. A breast cancer diagnosis and treatment heralds a series of frightening events and can be a traumatic experience. The manner in which women perceive and cope with their illness is predictive of emotional and physical health outcomes. It is thus imperative to explore the experiences of South African women, whose voices may have been silenced in the past. The purpose of my study was to explore the subjective lived experiences of women with early stage breast cancer undergoing treatment. The objectives of the study were to; explore the emotional experiences of women with early stage breast cancer undergoing treatment and secondly to explore how women perceive their bodies through their experience of early stage breast cancer while undergoing treatment. Phenomenology was used as the theoretical position conceptualising the study as well as the research design. This research study adopted a qualitative approach utilising in-depth face to face semi-structures interviews for collecting data. The participants were selected through purposive sampling and comprised six women aged between 30 and 40 who are undergoing treatment for early stage breast cancer. The data was analysed using interpretative phenomenological analysis. Emotions experienced were characterised by the shock of the diagnosis due to factors such as lack of family history and age. Participants reported positive changes and viewpoints which they gained through their breast cancer journey. Emotions were heightened during treatment due to the physical change experienced and the effects this had on family members and the general public. Furthermore, results indicated that participants, even though they discovered a new found love for life and for their wellbeing, neglected their emotional needs in order to protect family members. An additional reason for this neglect centered on the lack of understanding other individuals may have regarding the experiences of participants. Recommendations involves the encouragement of accessing counselling services and that interventions tailored to the needs of each patient especially according to age. All ethical considerations as stipulated by the University of the Western Cape were adhered to.
5
Sunkara, Ranga Rao. "Comparative study of breast cancer in the United States, India, and South Africa: 1996- present". DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2001. http://digitalcommons.auctr.edu/dissertations/1693.
Testo completoAbstract (sommario):
This study identifies forces that prevent or contribute to women's participation in breast cancer screening and other breast cancer prevention activities. The study was based on the premise that women from the lower socioeconomic groups in India, South Africa, and the United States had a higher rate of breast cancer because they are diagnosed at the more advanced stages of the disease and do not engage in breast screening opportunities. Moreover, there is limited access to services and transportation, and there is little faith in the professional health care provider and the treatment received from the health care provider.
Surveys and interviews were used to assess the women's level of involvement in breast cancer related prevention programs. Similar methods were used to assess the level of involvement by health care professionals in providing breast cancer prevention activities.
The researcher found that the issues related to breast cancer are comparable in South Africa, India, and the United States. Further, it was found that, for the women in all three countries, there was a lack of access to health care; thus, women were not receiving the medical treatment they needed; the women were diagnosed at the more advanced stages of the disease; there was a lack of available transportation to the sites where they could participate in health prevention programs; there was a lack of information about breast cancer made available to women of color; and the level of participation in health care programs is related to the socioeconomic conditions and to the cultural aspects of some women's lives and the long waiting periods for medical services.
The conclusion drawn from the findings suggests that a culture-sensitive model is needed for women of color, and health care professionals need to be more sensitive to the needs of women regardless of socioeconomic level. The three countries should consider holding global workshops on breast cancer, and health clinics and other medical facilities should send reminder cards to female patients or have health care workers do home visits to remind patients of the need for mammogram.
6
Ng'ang'a, Mukuhi. "Delay in provision of breast cancer care in patients seen at a district hospital diagnostic breast unit in South Africa". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/28069.
Testo completoAbstract (sommario):
Background: There is evidence to show that delays in breast cancer management are detrimental to patient outcome. The aim of this study was to determine time trends and causes of delay in a newly established diagnostic breast clinic based at a district hospital in South Africa. Method: All patients who presented to Mitchells Plain District Hospital Breast Clinic from January to December 2015 and had a diagnosis of breast cancer were included in this study. The intervals between the time she first noted her symptoms to initial contact with a health professional and delivery of definitive therapy was documented. Patient delay referred to the interval from when the patient first noted her symptoms to her initial contact with a health care provider. Provider delay referred to the interval between the first hospital visit and onset of therapy. Result: A total of 33 patients were enrolled in this study. The median overall total delay (time lapse between the moment the patient first noticed her symptoms to time definitive anti-cancer treatment was started) was 157days, (range 29 to 839 days). Median patient delay (time lapse between the moment the patient first noticed her symptoms and the visit to a health professional) was 56 days, (range 7 to 730 days). Median overall provider delay (time lapse between the patients' first encounter with a clinician to time definitive anti-cancer treatment was started) was 84 days, (range 22 to 338 days). Median Referral delay was 11 days (range 4 to 39 days). Median Diagnostic delay was 15 days (range 9 to 135 days) and median treatment delay was 45 days (range 5 to 246 days). Conclusion: The median overall total delay for patients diagnosed with breast cancer at Mitchells Plain District Hospital does not compares well with institutions in developed nations but it is similar to studies done in developing nations. The largest contributor to this delay was patient delay. The main contributors to provider delay was related to diagnosis (almost exclusively related to tissue diagnosis) and treatment (mainly patients who received surgery as their first definitive therapy).
7
Kamanga, Thembekile Nokukhanya. "A microsociological analysis of social support to women diagnosed with early stage breast cancer". Thesis, University of the Western Cape, 2016. http://hdl.handle.net/11394/5536.
Testo completoAbstract (sommario):
Magister Artium - MAThis study explored the social support provided by family of women diagnosed with early stage breast cancer. The aim was to present an account of social support that is solicited by and given to women diagnosed with early stage breast cancer. There is a dearth amount of literature on support from families of women with breast cancer in South Africa. Thus, this study can potentially contribute to filling the gap of knowledge in this area in the country. Qualitative method was used and in-depth interviews were utilized to study the women's experience of family social support. The theoretical framework underpinning the study is the relational communicational perspective.
8
Hassan, Mohammed Hashim Abdalraheem. "Characterization of ATP-binding cassette drug transporters and their role in breast cancer treatment using in silico approach". University of the Western Cape, 2019. http://hdl.handle.net/11394/7255.
Testo completoAbstract (sommario):
>Magister Scientiae - MScBreast cancer is the most common cancer in women worldwide, and is the second most common cancer in the world, responsible for more than 500 000 deaths annually. Estimates are that 1 in 8 women will develop breast cancer in their lifetime. In South Africa, breast cancer in women affects about 16.6 % of the population and could see a 78 % increase in cases by 2030. Comprehensive therapy on breast cancer including surgical operation, chemotherapy, radiotherapy, endocrinotherapy, etc. could help, but still has serious side effects. The Chemotherapy resistance against anticancer drugs is an emerging concern. Biomarkers have been identified as a viable option for early detection and progression of disease. Examples of biological indicators for disease could be the ATP-binding cassette (ABC) drug transporters that utilizes the energy derived from ATP hydrolysis to efflux many chemically diverse compounds across the plasma membrane, thereby playing a critical and important physiological role in protecting cells from xenobiotics. These transporters are also implicated in the development of multidrug resistance (MDR) in cancer cells that have been treated with chemotherapeutics. High expression of these membrane proteins as a family of ABC drug transporters are one of the main reasons for drug resistance by increasing the efflux rate of the anti-cancer drug from cancer cells. ABC drug transporters are considered to be one of the largest protein families in living organisms. There are 48 genes in the human genome that encode ABC transporters, which are divided into seven subfamilies (ABCA-ABCG). Studies revealed that ABC transporter genes has been shown to be associated with tumour development, progression and response to therapy, suggesting their possible use as diagnostic, prognostic and predictive biomarkers. The aim of this study was to investigate and identify novel ABC transporter genes that could be implicated in breast cancer and MDR and potentially would be a therapeutic target for successful chemotherapy treatment and disease progression and survival in breast cancer patients. An in silico approach was used to identify 10 ABC transporter genes (ABCB2, ABCB9, ABCB10, ABCC1, ABCC4, ABCC5, ABCC10, ABCC11, ABCC12, ABCD1) implicated in breast cancer by conferring drug resistance through over-expression in cancer cells. The in silico study investigated the tissue expression specificity, protein interaction/s, pathways, and comparative toxicogenomics of the identified ABC transporter genes using several computational software such as Tissue-specific Gene Expression and Regulation (TiGER), the Human Protein Atlas (HPA), Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), and The Comparative Toxicogenomics Database (CTD). The 48 ABC transporter genes were shortlisted through very selective criteria that narrowed the genes down to 10. Differential expression analysis of the genes using TiGER and HPA compared expression in normal versus cancerous tissue of the candidate genes. The result showed that ABCC11 was preferentially expressed in breast tissue with an enrichment value higher than 10.0. The results also showed ABCC10 overexpressed in breast cancer tissue, making these two genes top candidates for further analysis. Result from STRING database showed a strong functional interaction network between the prioritized genes through protein homology, co-expression and text mining as evidence for the observed interactions. Furthermore, the prioritized list of genes was submitted to the CTD for intersectional analysis to obtain the toxicity relationship between the genes and the Tamoxifen as the first line chemotherapeutic treatment for breast cancer. Venn diagrams obtained from CTD showed intersectional relation between ABCB2, ABCC1, ABCC4, ABCC11, and ABCD1 genes and Tamoxifen. Furthermore, an in silico validation of the prognostic/predictive values of the 10 prioritized genes (list 2) was carried out using an online biomarker validation tool and database for cancer gene expression data using survival analysis (SurvExpress) and gene expression based survival analysis web application for multiple cancer (PROGGENE). Results obtained from the PROGGENE survival and predictive analysis showed good prognostic values for the genes ABCB2, ABCC1, ABCC4, ABCC10 and ABCC12 with their significance measured by the probability value (Pv) (0.053, 0.001118, 0.01286, 0.00604, 0.00157 respectively). From this study ABCC1, ABCC4, ABCC5, ABCC10, and ABCC11 genes could serve as putative therapeutic target biomarkers for breast cancer treatment following further in depth analysis. However, the variance in the effectiveness of individual genes suggests that the set of genes would perform better than individual gene in the management of breast cancer. The modulating roles of ABCC4, ABCC5 ABCC10, and ABCC11 in drug induced apoptosis, suggest they could probably play an important role in personalized medicine and could serve as biomarkers to monitor the prognosis and/or therapeutic outcome of chemotherapy drugs in breast cancer patients. The use of modern genomics, proteomics, bioinformatics, and systems biology approaches has resulted in a substantial increase in our ability to identify molecular mechanisms that are involved in MDR in cancer and to find drugs that may block or reverse the development of drug resistance. By using an in silico approach in this study, a list of five ABC transporter genes were identified, of which two (ABCC10 and ABCC11) could potentially serve as prognostic and predictive biomarkers for the management of breast cancer treatment.
2022-04-30
9
Winchester, Carolyn Margaret. "Anti-p53 and c-erbB2 as prognostic markers in South African breast cancer patients". Thesis, Cape Technikon, 2000. http://hdl.handle.net/20.500.11838/1518.
Testo completoAbstract (sommario):
Thesis (DTech(Biomedical Technology))--Cape Technikon, Cape Town, 2000The diagnosis of breast cancer is not possible using currently available serological detection of cancer markers as these lack adequate sensitivity or specificity. This study investigates the prevalence and significance of anti-p53 antibody and c-erbB-2 protein in the post-surgical sera of South African breast cancer patients and correlates these features with the clinicopathological characteristics of breast cancer. Further, this study investigates the possibilityofimproving prognostic sensitivityby combining the two subject markers to monitor each patient. Further, this study will provide the opportunity to investigate lNhether only certain types of breast cancer can elicit an immunological response and at what stage and grade of tumour antibodies are present in the postoperative serum. The study also establishes a foundation for determining in South Africa lNhether there is a genetic influence in the response to p53 mutation and INhther this response is higher in the indigenous African women compared to other South African women. The purpose of the study is to determine if the resulting findings can be used to enhance our ability to diagnose breast cancer and to identify node-negative breast cancer patients at high risk for early disease recurrence and or death, for 1Nh0m adjuvant therapy is unequivocally justified. The study accrued 92 South African breast cancer patients who were essentially women of colour 62 [67%] indigenous African women and 20 [22%] Caucasian of Indian descent, 6 [6%J of mixed [ColouredJ background and only 4 [4%J Caucasian of White descent. A predominantly indigenous African populationwas chosen becausethey are the group most likely to benefitfrom an easily repeatable, affordable serological cancer marker.
10
Mentoor, J. L. D. (Juliet Lewie Dionee). "Identification of rare gene variants in South African breast cancer families through next generation sequencing". Thesis, University of Pretoria, 2017. http://hdl.handle.net/2263/63043.
Testo completoAbstract (sommario):
Breast cancer (BC) has become the leading cancer amongst women in South Africa. The
overall life time risk for developing this disease is one in 12 (National Cancer registry, 2000-
2011). A strong family history (≥3 affected) is an important factor for inherited predisposition to
BC that accounts for approximately 10% of cases worldwide. Mutations in several high- and
moderate risk breast cancer genes have been associated with familial BC and includes
BRCA1, BRCA2, TP53, PALB2, and CHEK2. Individuals that carry germline mutations in
BRCA1 and BRCA2 possess an 80% lifetime risk for BC. Mutations in BRCA1 and BRCA2 are
responsible for 29% and 25% of familial BC worldwide. In South Africa BRCA1 mutations
account for 19% and BRCA2 for 47% of familial breast cancer. Mutations associated with a
moderate risk for BC account for ~1% of cases. This data suggests that ~30% of South African
BC families are not characterised by pathogenic mutations in known breast/ovarian (BC/OVC)
genes. The purpose of the present study was to identify gene variants that may predispose to breast
cancer. Next generation sequencing was performed to investigate the germline DNA of highrisk
BC/OVC families that have previously tested negative for premature truncating mutations
in BRCA1/2, PALB2 and RAD51C. Paired-end whole exome sequencing was performed with
nine index cases, selected from six families with a strong background for BC/OVC. This
resulted in the discovery of an average of 26 000 coding variants in index cases. Gene
prioritisation strategies were incorporated to filter all exome variants and identify high-priority
genes for further analysis. After sequence verification, three high-priority genes were selected
for further analysis. The three genes coded for; a novel putative tumour suppressor (TCHP) that is pro-apoptotic;
the XPF-endonuclease homolog, EME2; and a POLQ like helicase enzyme (HELQ). Prioritised
genes were screened in a total of 61 high-risk families and cohorts of patients with BC or OVC
without a family history for their disease. Two potentially damaging variants (stop-gain & inframe
amino acid deletion) were identified in TCHP, four (frameshift, nonsense & two in-frame
deletions) in EME2 and one frameshift mutation in HELQ in high-risk families and cases that
were without a family history for BC/OVC.
The analyses performed in the last section of this project was aimed at identifying other
potential genes of interest by making use of a list of 516 well recognised and putative DNA repair genes. Through this approach, one additional truncating mutation in POLN
(p.Q837SfsX7) was highlighted as a potential gene of interest for future investigation.
Despite the key roles that the high-priority genes play in their respective processes, the
present study could not verify that the potential loss of function variants discovered make an
appreciable contribution towards BC/OVC susceptibility in our setting. Further investigation is
necessary to validate their involvement in breast/ovarian cancer predisposition.Thesis (PhD)--University of Pretoria, 2017.
Genetics
PhD
Unrestricted
11
Gerber, Jaclyn. "Cytochrome P450 polymorphisms : relevance in two South African disease populations". Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53345.
Testo completoAbstract (sommario):
Thesis (MSc)--Stellenbosch University, 2003.ENGLISH ABSTRACT: With knowledge of the human genome increasing constantly we are continually faced with new and potentially groundbreaking methods for managing, treating and/or identifying diseases and predisposition to diseases and conditions at a genetic level. The human cytochrome P450 (CYP) super-family of genes code for enzymes that can participate in metabolism of drugs and foreign chemicals and in steroid synthesis and metabolism. Mutations in these genes may contribute to clinically relevant diseases. In this study, the effects of mutations within four CYP genes were evaluated in two South African disease groups - variegate porphyria and breast cancer. Variegate porphyria (VP) has an unusually high incidence in South Africa due to the R59W founder mutation in the protoporphyrinogen oxidase (PPOX) gene that causes a disruption in the haem biosynthetic pathway. VP presents with variable clinical symptoms and has a relatively low penetrance. It is expected that environmental factors and modifier genes play a role in the clinical expression of VP. CYP genes are implicated as candidate modifier genes for the expression of VP due to the function they have in metabolising many drugs contraindicated in porphyria patients, and the necessity of haem binding to the apoprotein to produce a functional CYP enzyme. This is the first study to investigate CYPs as possible modifier genes for VP clinical expression. Six CYP polymorphisms (CYPIAlml, CYPIAlm2, CYPIA2 - 734 C>A, CYPIBI 8372 A>C, CYP2D6*3, CYP2D6*4), associated with four CYP loci, were genotyped in a VP population and a suitable control population. The results observed are suggestive of CYPIAlml and CYPIBI playing a role as modifiers for the clinical expression of VP as they were significantly associated (P
AFRIKAANSE OPSOMMING: Met die konstante toename van kennis oor die mensgenoom kom ons voortdurend te staan voor nuwe metodes vir die beheer, behandeling en/of identifikasie van siektes en vatbaarheid vir siektes op 'n genetiese vlak. Die mens sitochroom P450 geensuperfamilie kodeer vir ensieme betrokke in die metabolisme van medisyne en ander chemiese stowwe en steroïed-sintese en -metabolisme. Mutasies in hierdie gene kan 'n bydrae lewer tot kliniese relevante siektes. In hierdie studie is die effek van mutasies in vier sitochroom gene bestudeer in twee Suid-Afrikaanse siekte groepe, variegate porfirie en borskanker. Variegate porfirie (VP) het 'n besonderse hoë frekwensie in Suid-Afrika as gevolg van die R59W stigter-mutasie in die protoporfirinogeen oksidase (PPOX) geen. Hierdie mutasie lei tot 'n versteuring in die heem biosintese padweg. VP presenteer met variërende kliniese simptome en het 'n betreklike lae penetrasie. Daar word vermoed dat omgewingsfaktore en kandidaat modifiserende gene 'n rol speel in die kliniese beeld van VP. Sitochroom P450 gene is geïdentifiseer as kandidaat modifiserende gene as gevolg van hulle rol in die metabolisme van verbode medikasie vir porfirie pasiënte, asook die binding van heem aan die apoproteïen wat noodsaaklik is vir die produksie van funksionele sitochroom P450 ensiem. Hierdie is die eerste studie wat sitochroom P450 gene as moontlike modifiserende gene vir die kliniese uitdrukking van VP ondersoek. Ses sitochroom P450 polimorfismes (CYPIAlml, CYPIAlm2, CYPIA2 -734 C>A, CYPIBI 8372 A>C, CYP2D6*3, CYP2D6*4) is ondersoek in beide 'n VP populasie en 'n geskikte kontrole populasie. Die resultate suggereer 'n rol vir CYPIAlml en CYPIBI in die modifisering van die kliniese uitdrukking van VP aangesien hulle betekenisvolle assosiasie (P
12
Araujo, Monica Rodrigues. "Perspectives and Experiences of Individuals Undergoing Predictive Testing for Hereditary Breast and Ovarian Cancer (HBOC) Syndrome in the Western Cape, South Africa". Master's thesis, Faculty of Health Sciences, 2018. http://hdl.handle.net/11427/30057.
Testo completoAbstract (sommario):
Breast cancer is the most common malignancy affecting females globally. Hereditary breast and ovarian cancer (HBOC) syndrome is caused by pathogenic variants in BRCA1 and BRCA2 and is seen in approximately 50% of families with a strong history of breast and ovarian cancers. Predictive testing (PT) is offered to unaffected individuals with a positive family history of HBOC, with an already identified BRCA1 or BRCA2 mutation in an affected family member. There is an overwhelming amount of research that has focused on the after-effects of diagnostic genetic testing for HBOC but there has been little investigation into how individuals experience the actual PT process. The present study therefore aimed to investigate individuals’ decisions for undergoing and their experiences of PT for HBOC in a local context, by focusing on at-risk South African individuals residing in the Western Cape Province. Sixteen participants were recruited retrospectively from the breast cancer and/or clinical genetics clinics at Groote Schuur Hospital, Tygerberg Hospital and private genetic counselling practices in Cape Town. Semi structured interviews were conducted, and the interview transcripts were analysed using the framework approach for qualitative data analysis. Using this approach, five themes were identified relating to the perspectives and experiences of individuals undergoing PT for HBOC, in selected settings in the Western Cape. While some participants felt that their decision to pursue PT was influenced by their family history of cancer and the associated cancer-related distress, others felt that their decision was made out of a sense of duty to their families or in solidarity with those that were affected or received a positive test result. Overall, the participants felt that the pre-test counselling was beneficial in allowing for an improved understanding of HBOC, however not all participants felt that the pre-test counselling prepared them for receiving their results. Receiving a negative test result was often accompanied by feelings of guilt and did not exempt participants from the fear of developing cancer. Some of the concerns raised by participants that received a positive test result were centred around prophylactic intervention and its effect on body image. Overall, participants felt empowered by their mutation status and felt that they were better able to manage their risk. The need for additional support, both practical and emotional support, was particularly evident amongst mutation-carriers. The findings of this study provide valuable insight into the perspectives and experiences of this population, which could potentially impact the services that are provided to individuals undergoing PT for HBOC in similar settings.
13
Chilwesa, Paul Mambwe. "Comparison of 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (18F-FDG PET/CT) and conventional imaging (CI) for locally advanced breast cancer staging: a prospective study from a tertiary hospital cancer centre in Western Cape". Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31433.
Testo completoAbstract (sommario):
Background: Breast cancer is the second most common cancer in adults and the most frequent cancer diagnosed in women. In South Africa, breast cancer accounts for 38.5% of cancers diagnosed in women. Since the presence, extent and location of distant metastases is one important prognostic factor in locally advanced breast cancer (LABC), accurate staging at diagnosis is crucial to ensure patients receive the appropriate treatment. Increasing evidence shows that the use of 18F-FDG PET/CT for disease staging of LABC may improve diagnostic sensitivity.
Aim: To prospectively assess the difference in diagnostic accuracy between whole-body PET/PET-CT and conventional imagine (CI) for staging LABC.
Methods: A total of 42 participants with clinical stage III and a select few stage II breast cancer underwent both 18F-FDG PET/CT and CI.
Results: 18F-FDG PET/CT found significantly more (p=0.0077) distant metastatic sites than CI (36% vs. 21%). 18F-FDG PET/CT upstaged 9 (21.4%) of patients from clinical stage IIIa to stage IIIc, and changed management of 54% of patients. Thirty-eight percent (38%) of the patients had their clinical stage unchanged. One of 5 suspected metastatic sites 18F FDG PET/CT was positive for malignancy on biopsy.
Conclusion: The 18F-FDG PET/CT is useful for staging locally advanced non-inflammatory infiltrating ductal carcinoma of the breast. Use of 18F-FDG PET/CT was superior to conventional imaging in assessing metastatic mediastinal lymphadenopathy, but with a poor specificity. The use of 18F-FDG PET/CT in LABC is useful, with the biopsy of isolated suspicious lesions for metastasis increasing its accuracy.
14
Grant, Kathleen Ann. "Analysis of the clinical utility of gene expression profiling in relation to conventional prognostic markers in South African patients with breast carcinoma". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95824.
Testo completoAbstract (sommario):
Thesis (PhD)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Breast cancer is a heterogeneous disease characterised by marked inter-individual variability in presentation, prognosis and clinical outcome. The recognition that morphological assessment has limited utility in stratifying patients into prognostic subgroups led to clinico-pathological classification of tumour biology, based on receptor expression using immunohistochemical (IHC) techniques. This standard is currently complemented by the development of gene expression profiling methodology that led to the identification of intrinsic molecular subtypes, reflecting tumour genetics as the true driver of biological activity in breast cancer. The study was based on the hypothesis that molecular classification of breast carcinomas integrated with established clinico-pathological risk factors will improve current diagnostic and risk management algorithms used in clinical decision-making. A pathology-supported genetic testing strategy was used to evaluate microarray-based gene profiling against diagnostic pathology techniques as the current standard. Clinico-pathological factors including age, number of positive axillary nodes, tumour size, grade, proliferation index and hormone receptor status was documented for 141 breast cancer patients (143 tumours) referred for microarray-based gene expression profiling between 2007 and 2014. Subsets of patients were selected from the database based on the inclusion criteria defined for three phases in which the study was performed, in order to determine 1) the percentage of patients stratified as having a low as opposed to high risk of distant recurrence using the 70-gene MammaPrint profile within the inclusion criteria, 2) correlation of HER2 status as determined by IHC and fluorescence in situ hybridisation (FISH) with microarray-based mRNA readout (TargetPrint), and 3) the relationship between hormone receptor determination as reported by standard IHC and molecular subtyping using the 80-gene BluePrint profile. Similar distribution patterns for MammaPrint low- and high-risk profiles were obtained irrespective of whether fresh tumour biopsies or formalin-fixed paraffin embedded (FFPE) tissue was used. During the first phase of the study, 60% of the 106 tumour specimens analysed with MammaPrint were classified as low-risk and 40% as high-risk using a newly-developed MammaPrint pre-screen algorithm (MPA) aimed at cost-saving. In the second phase of the study, performed in 102 breast tumours, discordant or equivocal HER2 results were found in four cases. Reflex testing confirmed the TargetPrint results in discordant cases, achieving 100% concordance regardless of whether fresh tumour or FFPE tissue was used for microarray analysis. For the third phase of the study 74 HER2-negative tumour samples were selected for comparative analysis. Statistically significant positive correlations were found between protein expression (IHC score) and mRNA (TargetPrint) levels for estrogen receptor (ER) (R=0.53, p<0.0001) as well as progesterone receptor (PR) (R=0.62, p<0.0001), while combined ER/PR tumour status was reported concordantly in 82.4% of these tumours. BluePrint was essential for interpretation of these results used in treatment decision-making. The MPA developed in South Africa in 2009 was validated in this study as an appropriate strategy to prevent chemotherapy overtreatment in patients with early-stage breast cancer. The use of microarray-based analysis proved to be a reliable ancillary method of assessing HER2 status in breast cancer patients. Risk reclassification based on the TargetPrint results helped to avoid unnecessary high treatment costs in false-positive cases, in addition to providing potentially life-saving treatment to those for whom it was indicated. While neither IHC nor TargetPrint estimation of intrinsic subtype correlated independently with the molecular subtype as indicated by BluePrint profiling, the ability to distinguish between basal-like and luminal tumours was enhanced when the combined protein and mRNA values was considered. Genomic profiling provided information over and above that obtained from routine clinico-pathological assessments. This finding supports the relevance of a pathology-supported genetic testing approach to breast cancer management, whereby advanced genomic testing is combined with existing clinico-pathological risk stratification methods for improved patient management.
AFRIKAANSE OPSOMMING: Borskanker is „n heterogene siekte wat gekenmerk word deur merkbare inter-individuele variasie in kliniese beeld, prognose en uitkoms. Die beperkings van morfologiese klassifikasie vir identifikasie van prognostiese subgroepe het gelei tot klinies-patologiese tumor karakterisering op grond van reseptor uitdrukking deur gebruik van immunohistochemiese (IHC) toetse. Hierdie standaard word tans gekomplementeer deur ontwikkeling van geenuitdrukking tegnologie wat gelei het tot die identifikasie van intrinsieke molekulêre subtipes, wat die tumor genetika reflekteer as die ware drywer van biologiese aktiwiteit in borskanker. Die huidige studie is gebaseer op die hipotese dat integrasie van die molekulêre klassifikasie van borskanker met konvensionele risiko klassifikasie skemas huidige diagnostiese en behandelings algoritmes kan verbeter vir kliniese besluitneming. „n Patologie-gesteunde strategie is gebruik om mikroplaat-gebaseerde geen profilering te evalueer teen standaard patologie diagnotiese tegnieke. Kliniese-patologiese faktore insluitend ouderdom, aantal positiewe aksillêre limfnodes, tumor grootte, gradering, proliferasie indeks en hormoon reseptor status is gedokumenteer in 141 borskanker pasiente (143 tumore) wat verwys is vir mikroplaat-gebaseerde geenuitdrukking profilering tussen 2007 en 2014. Pasiënt subgroepe is geselekteer uit die databasis volgens die insluitingskriteria soos gedefiniëer in die drie fases waarvolgens hierdie studie uitgevoer is, om vas te stel 1) watter proporsie pasiënte geklassifiseer word as lae- of hoë-risiko vir latere herhaling van die borskanker deur gebruik van die 70-geen MammaPrint profile binne die insluitingskriteria, 2) hoe korreleer HER2 status soos vasgestel deur IHC en fluoreserende in situ hybridisasie (FISH) toetsing met mikroplaat-gebaseerde RNA lesings (TargetPrint), en 3) wat die verwantskap is tussen hormoon reseptor status soos deur standaard IHC gerapporteer en molekulëre klassifikasie volgens die 80-geen BluePrint profiel. Soortgelyke verdelingspatrone vir MammaPrint lae- teenoor hoe-risiko profiele is waargeneem ongeag of vars tumor biopsies of formalien-gefikseerde paraffin bevattende weefsel gebruik is. Tydens die eerste fase van die studie is 60% van die 106 tumore as lae-risiko en 40% as hoë-risiko geklassifiseer met toepassing van die nuwe MammaPrint Presifting Algoritme (MPA) wat ontwikkel is met die doel op kostebesparing. In die tweede fase van die studie waar 102 tumore ingesluit is, het die resultate van vier gevalle verskil van mekaar of was onbepaald ten opsigte van HER2 status. Refleks herevaluering het die TargetPrint resultate bevestig in alle nie-ooreenstemmende gevalle, en 100% ooreenstemming is bereik ongeag of vars tumor biopsies of formalien-gefikseerde paraffin bevattende weefsel gebruik is vir mikroplaat analise. In die derde fase van die studie is 74 HER2-negative tumore selekteer vir vergelykende analise. Statisties beduidende positiewe korrelasies is waargeneem tussen proteïen uitdrukking (IHC) en mRNA (TargetPrint) vlakke vir die estrogeen reseptor (ER) (R=0.53, p<0.0001) sowel as progesteroon reseptor (PR) (R=0.62, p<0.0001), terwyl gekombineerde ER/PR reseptor status ooreenstemming getoon het in 82.4% tumore. BluePrint was noodsaaklik vir die korrekte interpretasie van die resultate wat gebruik is in kliniese besluitneming vir behandeling van pasiënte. The MPA wat in Suid Africa ontwikkel is in 2009, is gedurende hierdie studie bevestig as n toepaslike strategie om onnodige handeling met chemoterapie te voorkom in pasiënte met vroeë stadium borskanker. Die gebruik van mikroplaat-gebaseerde analise is aangetoon as „n betroubare aanvullende metode om HER2 status te evalueer. Risiko herklassifikasie gebaseer op TargetPrint resultate het onnodige hoë behandelingskoste in vals-positiewe gevalle vermy, sowel as om die verskaffing van potensieël lewensreddende behandeling vir die toepaslike pasiënte te verseker. Genomiese profilering het inligting addisioneel tot dit wat met roetine klinies-patologies metodes verkry kan word verskaf. Hierdie bevinding ondersteun die relevansie van „n patologie-gesteunde genetiese toets benadering tot hantering van borskanker, waardeur genomiese toetsing gekombineer word met bestaande klinies-patologiese risiko stratifisering metodes om pasiënt behandeling te verbeter.
15
Van, der Walt Jacobus Gert. "Radiation field shaping through low temperature thermal-spray in radiotheraphy". Thesis, Bloemfontein : Central University of Technology, Free State, 2009. http://hdl.handle.net/11462/116.
Testo completoAbstract (sommario):
Thesis (D. Tech.) -- Central University of Technology, Free State, 2009Superficial cancerous lesions are commonly treated through low energy X-ray or electron radiation in radiotherapy. The treatment units that produce the radiation are equipped with square, rectangular and round applicators of different sizes. These applicators attach to the treatment units and define the radiation field size applied during treatment. An applicator is chosen to fit the shape of the cancerous lesion on the patient as closely as possible. Since cancerous lesions are irregular in shape, there will always be an area of healthy tissue between the edge of the lesion and the edge of the standard field shape. This healthy tissue will be irradiated along with the lesion during treatment which is undesirable since the cancer wound heals through reparative growth of the surrounding healthy tissue after treatment. Traditional techniques that were developed to shield this healthy tissue and thus shape the radiation field to the shape of the lesion present various shortcomings. This study introduces a new thermal-spray process for producing radiation field shaping shields which overcomes most of the shortcomings encountered with the traditional field shaping techniques. Since none of the commercially available thermal-spray equipment could be used to produce field shaping shields, new thermal-spray equipment was designed and fabricated tailor made to the application. Different techniques to determine the contours of the treatment area on the patient were investigated. These included a patient contact technique using a plaster bandage impression and a non-contact technique using 3D laser scanning. From the plaster bandage impression a plaster model can be produced onto which a high density low melt material such as Wood’ s alloy can be thermally sprayed to produce a field shaping mask. A model can also be produced from the 3D laser scanning data through laser sintering (LS) in nylon polyamide powder or through computer numerical controlled (CNC) milling in a block of low density polyurethane. The thermal-spray technique was evaluated by comparing the field shaping ability of radiation shields produced through the technique to the field shaping ability of shields produced through the traditional techniques. Radiographic film was used for this purpose and the results are presented in the form of isodensity charts. The required thicknesses of thermal-sprayed field shaping masks to shield radiation of various energies were also determined. The thicknesses were determined through radiation transmission measurements of known thicknesses of sprayed sheets of Wood’ s alloy. X-ray imaging showed that there were no defects present within thermal-sprayed layers of Wood’ s alloy that may negatively affect the shielding ability of masks produced through the technique.
16
Abulkasim, Muna Abdussalam Owen. "The prevalence of breast cancer in Africa and establishment of The Libyan Breast Cancer Registry". Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32180.
Testo completoAbstract (sommario):
Breast cancer is well-known globally and remains one of the principal health concerns affecting women, and a rare malignancy in men. Although, there has been significant progress made in prevention strategies such as early detection and better treatment in most developed countries, incidence and mortality rates of breast cancer continued to rise. The rise is significant in Africa, a continent low in resources with a growing and ageing population exposed to risk factors leading to developing the disease. Although the incidence of breast cancer is lower in Africa than in high-income countries, mortality rates are high, mainly in women less than fifty years of age. Like most African countries, Libya is least prepared to cope with breast cancer and cancer in general. Additionally, many Libyans are adopting unhealthy lifestyles together which, together with environmental changes and high life expectancy, is perhaps the cause of rising cancer rates. However, no systematic collection of breast cancer incidence is currently undertaken, which in turn, impacts the implementation of detection and treatment measures. This thesis sought to evaluate the situation of breast cancer in Africa and specifically, for Libyan patients, through a systematic review of prevalence studies in Africa and by designing a registry for Libyan breast cancer patients. Objectives : • To conduct a systematic review and literature-based meta-analysis to provide an evidence-based estimate of the prevalence rate of breast cancer in Africa. This systematic review provides epidemiological data to guide health practitioners, educators and researchers for further studies needed in the field of breast cancer, specific for African patients. • To design a breast cancer registry for Libyan breast cancer patients. Developing a Libyan breast cancer registry provides an opportunity to learn more about disease development, and the changes through the course of the patient's life. Secondly, we will be able to track the incidence, mortality, and survival of patients diagnosed with breast cancer and their distribution in Libya. Finally, the information will be translated into numbers to aid policymakers in measuring the extent of the problem and help researchers in taking action needed to reduce the breast cancer load in Libya. Methods: • A systematic literature search was performed to identify studies retrieved from electronic databases, grey literature and reference lists, with no time and language limits. We have reviewed the available studies addressing the prevalence rate of breast cancer for African patients living in Africa who developed the disease. • Secondly, the Libyan Breast Cancer Registry (LBCR) is a prospective, hospital-based registry planned to document clinical and imaging characteristics of patients at presentation. Through follow-up, we will document disease progression and treatment practices to reliably determine the incidence of all-cause mortality and worsening disease requiring hospitalization. Results: • The overall prevalence rate of breast cancer in Africa was 0.30 [ 95% CI, 0.26 to 0.34] (22 studies, n=10,795). The prevalence rate of breast cancer for African females was 0.49 [95% CI, 0.38 to 0.62]. South African region had the highest breast cancer prevalence rate, 0.65 [95% CI, 0.24 to 1.26], while the lowest rates of breast cancer were from Central African regions. The use of mammography yielded higher rates of detection, (0.63 [95% CI, 0.46 to 0.82]), in comparison with clinical breast examination (0.31 [95% CI, 0.22 to 0.42]). • The proposed LBCR comprises parts I, II, AND III. Part I consists of demographic data and cancer information detailing personal data such as medical history, general examination, breast examination, methods and results of the diagnosis, and the treatment offered. Part II comprises the forms used for continuous follow-up – a new form is completed at each visit. All new information regarding patients' details, new complaints, and investigation findings and any changes or treatment offered at the visit, are recorded in this section. Part III documents mortality information. Details are recorded accompanied with a copy of the death certificate, and an autopsy report in case it was required. The LBCR pack includes consent forms in both English and Arabic languages. Also, it is accompanied by a manual of operation with given answered examples. Furthermore, the form is provided with contact details in case of any required information or explanation needed in the future. Conclusion: The clinical picture of breast cancer in Africa differs from Western countries due to the high proportion of patients developing the disease at a younger age and seeking management care at an advanced stage. Currently, there exists no specific breast cancer registry designed specifically for any African patients living in Africa. The LBCR will provide comprehensive, contemporary data on patients with breast cancer through establishing a baseline figure of the current situation for future local and national comparisons. The LBCR includes ready and accessible information for the temporary and future use of medical elements and researchers in this field and will help in the development of strategies to prevent and manage breast cancer and its complications.
17
Jedy-Agba, E. "Breast cancer in sub-Saharan Africa : determinants of stage at diagnosis and diagnostic delays in women with symptomatic breast cancer". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/3928323/.
Testo completoAbstract (sommario):
Background: Breast cancer is the most common female cancer worldwide and in sub-Saharan Africa (SSA). Breast cancer incidence in SSA is relatively low but, as survival from the disease in the region is poor, mortality rates are as high as in high income countries. Late stage at diagnosis, and delays in a woman’s journey to a cancer diagnosis, are features known to contribute to poor breast cancer survival rates. There has been little focus on the factors affecting stage at diagnosis and the determinants of diagnostic delays in SSA despite previous studies highlighting the importance of early detection and treatment in breast cancer control. Aims and Methods: The main objectives of this thesis are: (i) To conduct a systematic review and meta-analysis of stage at breast cancer diagnosis in SSA to examine trends over time and examine possible sources of variation across the region. Random-effects meta-analyses were performed to investigate between-study heterogeneity in percentage of late-stage disease (stage III/IV) breast cancer, and meta-regression analyses were carried out to identify possible sources of variation. Percentages of Black women with late-stage breast cancer in SSA were compared with equivalent estimates for US Black and White women using the Surveillance, Epidemiology and End Results Database. (ii) To design and conduct a study, the Nigerian Integrative Epidemiology of Breast Cancer (NIBBLE) study, (iii) to investigate determinants of late stage at breast cancer diagnosis and diagnostic delays at six tertiary and secondary health facilities in Nigeria. Ordinal logistic regression was used to examine associations of socio-demographic, breast cancer awareness, health care access and clinical factors with the odds of later stage disease. Linear regression analyses were performed to examine the association of these factors with time from noticing symptoms to diagnosis (total delay), and its two main 4 components: pre-contact delay (i.e. time from symptoms to first contact with any care provider including traditional healers) and post-contact delay (i.e. time from first contact to diagnosis). Results: (i) Systematic review: 83 studies were eligible representing 26,788 women from 17 SSA countries. There was wide variation in percentage of late stage (median 74.7%, range 30.3-100%, I2=93.3% p < 0.0001). Late stage at diagnosis was notably higher in Black vs non-Black women in SSA and higher for populations from mixed (urban and rural) settings than from urban settings. The percentage of women with late stage breast cancer decreased over time but it was still higher than in US White and Black women 40 years previously. (ii) Findings from NIBBLE: 300 breast cancer patients were recruited, 67.7% with late stage (III/IV) at diagnosis. Multivariate analyses showed lower educational level (odds ratio (OR) 2.35; 95% confidence interval (CI) 1.04, 5.29), not believing in a cure for breast cancer (OR 1.81; 95% CI 1.09, 3.01), Muslim religion (OR 0.46; 95% CI 0.22, 0.94) and living in a rural area (OR 2.18; 95% CI 1.05, 4.51) to be significantly associated with later stage. No associations were found between later stage and age at diagnosis, tumour grade or oestrogen receptor status. Women diagnosed in stages III/IV self-reported, on average, 36% longer total delay times than those in stages I/II. Median (IQR) for pre-, post and total delays were 2.6 (0.6, 8.3), 3.1 (0.79, 8.7) and 7.8 (3.3, 18.7) months, respectively, for all women who presented with suspicious symptoms (n=430). In fully-adjusted analyses, post-contact delays in all women with symptoms were associated with lack of a personal income (OR 1.49; 1.04, 2.00), no previous history of benign breast disease (OR 0.61; 0.42, 0.89) and having 5 or more children (OR 1.88; 95% CI 0.96, 3.67) whilst total delay was inversely associated with presentation at a secondary facility (OR 0.68; 95% CI 0.51, 0.92) and no previous history of benign breast disease (OR 0.64; 0.47, 0.88). Post-contact and total delays were both positively associated with the total number of providers visited before a diagnosis (P for trend (Pt)=0.014 and Pt < 0.001, respectively). Only 18% of all women with symptoms and 12.4% of the subset with breast cancer were diagnosed within 3 months of noticing a breast symptom. Conclusions: Although stage at breast cancer diagnosis improved over time in SSA, it is still a common feature. This thesis identified factors amenable to intervention such as breast cancer awareness and health care access, rather than intrinsic tumour characteristics, as the main drivers of late stage at diagnosis in Nigeria. Strategies for early diagnosis of symptomatic breast cancer should be regarded as a major priority in cancer control programmes in SSA.
18
Ndui, Mary K. "Epidemiology of oral cancer in South Africa 1996-2002". Thesis, University of the Western Cape, 2011. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8665_1367481245.
Testo completoAbstract (sommario):
Oral cancer is characterised by marked geographical differences in frequency and site preference as reported by various studies. In South Africa, a few studies have been reported on the patterns and aetiology of oral cancer, and age standardised incidence rates (ASIR). Studies in several countries have shown an increase in oral cancer incidence among younger people. Title:
Epidemiology of oral cancer in South Africa 1996-2002.
Aim and Objective: The aim of this study was to determine the age standardised incidence rates (ASIR) of oral cancer by age, gender, race
and site in South Africa for a consecutive period of seven years. Method: Pathology case records of oral cancer diagnosed over a seven-year period from 1996 to 2002 and reported to the National
Cancer Registry (NCR) were analysed for age, sex, race, and date of diagnosis, basis of diagnosis, topography and tumour type. The data was tabulated and categorised using Microsoft Excel. The South African population size for each year of the study was estimated by linear extrapolation using the 1996 and 2001 census results. Age standardisation incidence rates against the world
population were calculated by the standard direct method. Results: The total number of oral squamous cell carcinoma cases over the 7-year period was 9702. The majority of cases (34%) were
on the tongue. The male to female ratio was 1:3. The age standardized incidence rates in this study was lower among African women
(0.640 per 100000 per year) and the highest was 13.40 new cases per 100000 per year (coloured males). Lip cancer was highest among both males and females of the white population. The cumulative rate of developing oral cancer was 1:83 and 1:32 for males and females respectively.
19
Opoku, Samuel Yaw. "Knowledge, attitudes, beliefs, behaviour and breast cancer screening practices in Ghana, West Africa". Thesis, City University London, 2007. http://openaccess.city.ac.uk/8570/.
Testo completoAbstract (sommario):
Breast cancer is both the most common cancer and the leading cause of cancer related death among women around the world. The incidence of the disease is generally considered higher among women in the developed countries than the developing countries; however, the mortality rates for women in the developing countries meet or exceed those of the developed world, indicating poorer prognosis (Pannuti et al., 2000; WHO, 2000; IARC, 2001; IARC, 2002; Anderson et al., 2003; Tannerberger et al., 2004). Ghanaian women, like many other women from the developing countries, have a low participation rate in breast cancer screening services. As a result, the disease is commonly diagnosed at late stages leading to a poor outcome with high mortality rates. Efforts toward reducing the mortality from breast cancer should be focused on implementing cost-effective public health strategies to improve early detection and appropriate treatment (Pannuti et al., 2000; WHO, 2000; IARC, 2001; IARC, 2002; Anderson et al., 2003, Tannerberger et al., 2004). The main objective of the study was to assess breast cancer related knowledge, attitudes, beliefs, behaviour and screening practices among Ghanaian women in the study areas. Investigating an issue such as the knowledge, attitude, belief and breast cancer screening practices is of great importance, not only in identifying obstacles to participation in breast screening and treatment, but also to guide the development of future health promotion programmes to improve breast cancer care in Ghana. The study was conducted in two phases, in Accra and Sunyani, both in Ghana. The first phase involved a total of 474 Ghanaian women aged between 40 and 70 years. Data collection was initially accomplished by using researcher-administered questionnaires, designed to obtain relevant socio-demographic characteristics, knowledge, attitudes, beliefs and practices towards breast cancer (Appendix iii pagel69). The questionnaire was pre-tested in a pilot study in Accra on 68 women before the major study. The second phase was accomplished by semi-structured interviews conducted on 10 breast cancer patients, 10 breast clinic attenders, 2 traditional healers and 3 Consultants, involved in breast cancer management in Ghana. Transcripts of the interviews appear in Appendices iv-vii page 178-231). Characteristics of the subjects that participated in the study are covered in the first part of the findings. The majority of the women who participated in the first phase, (49.2%) were between the ages of 40 - 45 years (table 6: 3: 2a page54). With regards to the education of the respondents, it was observed that in sum 85.9% of the respondents (table 6: 3: 3 page57) had received some level of education. On employment, the vast majority of respondents (74.3%) were engaged in the informal sector, 14.2% in the formal sector and 11.5% unemployed.
20
Amer, Akrem. "Epidemiology and Anatomic Distribution of Colorectal Cancer in South Africa". Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33624.
Testo completoAbstract (sommario):
Background: Colorectal cancer (CRC) is the 5th most common cancer in subSaharan Africa (SSA) and the 3rd most common cancer in Southern Africa. CRC characteristics in SSA, including anatomic distribution, are not well described. Objective: To describe patient characteristics and anatomic location of colorectal adenocarcinoma (CRC-AC) in South Africa. Design: This was a retrospective study of CRC using the South African National Cancer Registry from 2006-2011. Main Outcome Measures: Patient age, gender, racial/ethnic group, province, histology type, and tumour location. Results: 6146 patients were included in the analysis. Among patients with adenocarcinomas, the median age of presentation was 60 (interquartile range, 49-70) years. 1372 (25%) of patients were < 50 years and 2870 (52%) were male. There were 5498 (89%) cases of adenocarcinoma (AC). 1277 (26%) CRC-AC were right colonic lesions, 1214 (25%) were left colonic lesions, and 2404 (49%) lesions were located in the rectum. Patients ≥ 50 years at presentation (OR=1.29. p< 0.001) and from Limpopo province (OR=1.46, p=0.029) were more likely to have left colonic and rectal adenocarcinoma on multivariate analysis. Patients who were black (OR=1.67, p< 0.001), had right colonic lesions (OR=1.25, p=0.007), and were from Mpumalanga (OR=1.67, p=0.007), Limpopo (OR=1.60, p=0.002), or Northwest (OR=1.76, p=0.001), were significantly associated with early onset adenocarcinoma. Conclusion: CRC-AC in South Africa presents at an earlier age than in HICs, such as the US. Early-onset CRC is higher in black South Africans who live in Mpumalanga, Limpopo, and Northwest in comparison with other provinces. The majority of colorectal cancer were leftsided and rectal; thus screening flexible sigmoidoscopy should be considered. Further studies on the age-specific incidence and the genetics and epigenetics of CRC-AC in South Africa are needed.
21
Moodley, Jennifer Rose. "Prevention of cervical cancer in South Africa : opportunities and challenges". Doctoral thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/10990.
Testo completo
22
Sagoo, Parminder. "Experiences of South Asian women with breast cancer : coping via 'strength through connection'". Thesis, University of East London, 2010. http://roar.uel.ac.uk/1882/.
Testo completoAbstract (sommario):
The aim of this qualitative study was to gain a better understanding of how British South Asian women cope with breast cancer. The NICE (2004) Guidance suggests that appropriate psychological support should be available for all patients through all stages of their treatment from diagnosis to end-of-life. A literature review indicated a paucity of UK based studies on which to base practice. In order to understand the coping experience of this group, ten female South Asian patients being treated for breast cancer were recruited for in-depth semi-structured interviews, which were recorded and transcribed. Data were analysed using constructivist grounded theory to produce a model conceptualising the resources or processes that this group used in order to cope with breast cancer. Analysis elucidated 'Strength through Connection' as the core category, and four main categories: a) Being in mind, b) Wearing a positive cap, c) Preserving relational identity, and d) Realigning values. Facets of the extant coping literature support these findings but much of this research is not from an ethno-cultural perspective. The pattern of coping found in this study can be viewed holistically within a cultural framework and interpreted as predominantly collectivist coping, thereby highlighting the significance of connectedness. Clinicians are encouraged to be better informed regarding cultural differences and preferences in coping, and recommendations are made for counselling psychology practice. The need for further research to meet the NICE (2004) Guidance is highlighted.
23
Cheok, Frida. "Participation in mammographic screenings in South Australia /". Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phc51843.pdf.
Testo completo
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Ngugi, Pearl. "Response and adherence of HIV positive women to cervical cancer treatment". Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/d1014129.
Testo completoAbstract (sommario):
It is estimated that 6742 South African women are diagnosed with cervical cancer and 3681 women die from the disease every year. In 1993, The Centers for Disease Control declared cervical cancer an Acquired Immunodeficiency Syndrome defining illness. Apart from persistent human papillomavirus infection, HIV infection is the most common co-factor contributing to cervical cancer in South Africa. Studies have noted that in HIV positive women, there has been an occurrence of faster progression to more advanced stages of cervical cancer with high cases of treatment failure and recurrence. There is limited literature available regarding the prognosis of HIV positive women who suffer from cervical cancer. Women who are HIV positive and have cervical cancer have not been evaluated in detail regarding their response and adherence to cervical cancer treatment. Standard treatment protocols for this set of patients have not been defined. The aim of this study was to assess how HIV positive women who have been diagnosed with cervical cancer responded and adhered to cervical cancer therapy which includes: curative radiotherapy; curative chemotherapy; concurrent chemoradiation or palliative radiotherapy. The study also evaluated the effects of the concurrent use of antiretrovirals and cervical cancer treatment. This was done to determine whether invasive cervical cancer in women who were HIV positive could be managed using the same treatment protocols as patients who were HIV negative. A historical cohort design was employed for the study. The study was conducted at the Oncology Department of a tertiary level hospital located in the Eastern Cape Province, South Africa. The total sample consisted of 196 medical records of women diagnosed with cervical cancer between 2005 and 2008. One hundred women were HIV negative, 83 were HIV positive and the HIV status of 13 women could not be determined. The records were audited over a period of two years from the date of diagnosis. The term „complete response‟ referred to patients who had no recurrence of cervical cancer and no evidence of metastases after undergoing treatment. At one month following treatment there was a significant difference in the incidence of complete response between the HIV positive patients and the HIV negative patients (Chi2 = 16.4, d.f. = 1, p = 0.00005, Cramer‟s V = 0.31). The significant difference in response to treatment between the HIV positive patients and the HIV negative patients was maintained at six months after treatment (Chi2 = 15, d.f. = 1, p = 0.00011, Cramer‟s V = 0.34), 12 months after treatment (Chi2 = 20.5, d.f. = 1, p = 0.00001, Cramer‟s V = 0.37), 18 months after treatment (Chi2 = 9.8, d.f. = 1, p = 0.00173, Cramer‟s V = 0.28) and 24 months after treatment (Chi2 = 5.0, d.f. = 1, p = 0.02571, Cramer‟s V = 0.26). At each of these intervals, cases of treatment failure and metastases were significantly higher in the HIV positive women than in the HIV negative women. Although there was no significant difference in the incidence of adherence between the HIV negative women, the HIV positive women who were on HAART and the HIV positive women who were not on HAART, there was a significant difference in the incidence of the various reasons for non adherence between the various groups. These reasons included: missed scheduled appointments (Chi2 = 2.9, d.f. = 2, p = 0.02385, Cramer‟s V = 0.31); low blood count (Chi2 = 4.0, d.f. = 2, p = 0.01327, Cramer‟s V = 0.15); radiotherapy induced skin breakdown (Chi2 = 0.6, d.f. = 2, p = 0.04581, Cramer‟s V = 0.16) and radiotherapy induced diarrhoea (Chi2 = 6.9, d.f. = 2, p = 0.03118, Cramer‟s V = 0.19). According to the 2004 National Antiretroviral Treatment Guidelines, cervical cancer patients would fall into the WHO stage IV category of HIV disease thus all patients with confirmed diagnosis of invasive cervical cancer should be commenced on antiretrovirals as soon as the cancer diagnosis is made regardless of their CD4 count. However, in the current study, 13 percent (n= 83) of the HIV positive women were not on antiretrovirals. The study concluded that HIV positive women had a higher incidence of both treatment failure and metastases to cervical cancer treatment. Standard radiotherapy and concurrent chemoradiation cervical cancer treatment protocols should be still be used in both HIV negative patients and HIV positive patients so as not to compromise tumour control. Furthermore, in accordance with the antiretroviral treatment guidelines, all HIV positive patients with cervical cancer should receive antiretrovirals irrespective of their CD4 count.
25
Patel, Geeta. "The psychosocial impact of breast cancer diagnosis and treatment in Black and South Asian women". Thesis, University of the West of England, Bristol, 2013. http://eprints.uwe.ac.uk/20099/.
Testo completoAbstract (sommario):
Breast cancer is the most common form of cancer in women of all ethnic groups. The diagnosis and treatment of the disease can be challenging and distressing for any individual. Research in this area has documented a range of physical, psychological and social consequences. However, very little work within the existing literature captures the experiences of Black and Minority Ethnic (BME) women, especially in the UK. The limited available research, based on American studies, show that while similarities in White and BME women’s breast cancer experiences exist, there are also aspects that are unique and specific to BME women, which are influenced by socio-cultural norms, behaviours and beliefs. Therefore, the aim of this research was to explore the psychosocial impact of breast cancer diagnosis and treatment in British Black and South Asian women. To research this area, a qualitatively driven mixed method approach was adopted. Four studies were undertaken, 3 qualitative and 1 quantitative. The first study was exploratory in nature, in which semi-structured one-to-one interviews were carried out with 11 Black and 11 South Asian women. The findings of this study informed the subsequent studies, the second of which consisted of focus group interviews with 10 Black and 10 South Asian women to explore the ways in which breast cancer experiences are managed. The third study involved interviews with 5 South Asian Indian, Gujarati-speaking women (with limited English proficiency). The findings from these studies show that psychosocial and cultural factors (such as support, appearance concerns, healthcare experiences, cultural beliefs about cancer, understanding of cancer and language barriers) play an important role in shaping BME women’s experiences of breast cancer. These findings informed the development of the final questionnaire study. This study investigated the psychosocial impact of breast cancer and aimed to compare breast cancer experiences between White, Black and South Asian women. A total of 173 women participated (80 White, 40 Black and 53 South Asian). The results from this study show that psychological distress, social support and receiving chemotherapy treatment are associated with quality of life. Furthermore, similarities and differences in Black, South Asian and White women’s breast cancer experiences (in relation to psychological distress, quality of life, control beliefs (pertaining to cancer), body image concerns and sources of support) are evident. The findings from this research highlight important implications for policy makers, healthcare professionals and researchers to enhance awareness and understanding, and to ensure the provision of culturally competent care and support to future breast cancer patients.
26
Felix, Rebecca. "The molecular genetic and epidemiological investigation of colorectal cancer in South Africa". Doctoral thesis, University of Cape Town, 2003. http://hdl.handle.net/11427/3093.
Testo completoAbstract (sommario):
Bibliography: leaves 161-191.Cancer of the colon and rectum is the third-most common cause of death due to neoplasia in Western countries. Colorectal cancer (CRC) can broadly be divided into the hereditary, non-hereditary and sporadic forms. Hereditary cancers account for approximately 10% of the CRCs. Familial cancers can be divided into thos types in which polyps are a dominant feature (e.g. familal adenomatous polyposis-FAP) and the non-polypotic forms (e.g. hereditary nonpolyposis colorectal cancers-HNPCC).
27
Tailor, Bharti. "The experiences of South Asian women with breast cancer and the complexities of whole person care". Thesis, University of Southampton, 2008. https://eprints.soton.ac.uk/71891/.
Testo completoAbstract (sommario):
This study investigates the experiences of South Asian women being treated for breast cancer within a British system of health and social care that recognises racialised inequalities in care and is striving to provide culturally sensitive care to an increasingly diverse population. The research was conducted in a National Health Service (NHS) Trust in an outer London suburb. It is a qualitative exploratory study based on eighteen in- depth interviews and participant observation of interactions between women with breast cancer and health care professionals. The interviews were conducted in three languages: English, Gujarati and Hindi. In examining whole person care from the perspectives of both health care professionals and South Asian women, this thesis demonstrates how ethnicity as both a category of social difference and a process of social identification can present significant challenges for holistic care at different stages of the patient pathway. The concept of othering is used to make sense of the complicated relationships between health care professionals and South Asian women and to examine the extent to which care is responsive to differences of ethnicity, culture and faith. The findings from participant observation and qualitative interview data suggest that health professionals can often reduce the complex experiences of South Asian women to cultural difference. Such thinking can serve to compromise therapeutic relationships in which mutual power sharing and decision making is inhibited. However, cultural stereotyping is not a uniform process and can be transformed in situ so that some women are able to access personalised and holistic care. Whilst recognising that the needs of South Asian are complex evidence from this study suggests that othering can be a central process through which health care professionals contribute to the marginalisation of South Asian women within health care services.
28
Hanson, Victoria Funmilayo. "An empowerment programme for women on breast self-examination towards the prevention of breast cancer in Iddo Local Government, Oyo State, South-west Nigeria". University of the Western Cape, 2015. http://hdl.handle.net/11394/4682.
Testo completoAbstract (sommario):
Philosophiae Doctor - PhDCancer is a major public health concern in both developed and developing countries; it accounts for 13% of all deaths globally, of which 70% occur in middle- and low-income countries. In Nigeria, over 10 000 cancer deaths and 250 000 new cases of cancer are recorded yearly. Breast cancer is the second most common cancer worldwide, after lung cancer. It is the most common type of cancer diagnosed in women and the most common cause of death worldwide. Late detection and diagnosis of breast cancer leads to high mortality rate. In Nigeria certain cultural taboos are associated with breast cancer, which lead to poor information dissemination to women in rural communities. Breast self-examination (BSE) provides an inexpensive method for early detection of breast tumours. Knowledge and awareness about Breast Self-Examination are critical to promote consistent practices when the people concerned are empowered with the needed information to acquire the knowledge and skills which will inform practice of any health issue. In Nigeria it was reported that the number of women at risk of breast cancer increased progressively from 24.5 million in 1990 to about 40 million in 2010. This number is projected to rise to over 50 million by 2020, should the trend continue unabated. The current study explored the understandings of breast cancer and prevention, with particular emphasis on BSE practice among rural women, and developed an empowerment programme to promote uptake of this practice in a rural community in a south-western state of Nigeria. The study was framed in the Health Belief Model and Kieffer’s empowerment process. Participatory action research was used as study design and approach; and utilized both qualitative and qualitative methods. The sample for quantitative phase comprised 345 women aged 20 to 60 years, selected from 5 communities using a cross-sectional procedure. Data gathering instrument was a questionnaire. Summative statistics were calculated using the SPSS program. The sample for qualitative phase comprised of 95 women who were selected from the respondents to the quantitative phase. The data was collected through focus group discussion. The qualitative data was subjected to thematic analysis. Three themes that emerged for qualitative analysis which are: knowledge/awareness of BSE, practice and appeal for intervention, and misconception and fear. The survey results showed that a large proportion of the respondents (75.1% and 76.5%) had low levels of knowledge about BSE and did not practice BSE. Also, about 77% of the respondents expressed one form of barrier or another to BSE practice. However, despite these inadequacies, 87% of the respondents were ready and willing to improve their health if empowered with the right information and motivation. The empowerment program informed by the quantitative and qualitative phases and the stages of change with the full participation of the women. The program consisted of hands-on physical demonstrations, BSE pamphlets, and mnemonic songs were identified media of disseminating knowledge and practice of BSE. These media became the platforms for the empowerment programme developed for the women. A day was also set aside, just as is done for immunisation, for BSE practice and other women’s health issues to promote the prevention of breast cancer in the community. The “Physical demonstration” intervention resulted in an increase in the correct BSE practice from 23.5% at the beginning of the study, to 85.3% post the intervention. The “other intervention” resulted in 80% to 94.7% of participating women being able to practice correct physical step-by-step performance of BSE. The participatory approach contribute to a high levels of participation by women in Iddo local Government which led to the increase in the correct Breast Self–Examination as stated above.
29
Sewram, Vikash. "Risk factors for oesophageal cancer in the Eastern Cape Province of South Africa". Doctoral thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/9335.
Testo completoAbstract (sommario):
Includes bibliographical references (p. 196-245).A multicenter hospital-based case-control study with incidence density sampling was conducted between November 2001 and February 2003 to assess the impact of social and dietary habits, and the consumption of dietary and medicinal wild plants on the risk of developing oesophageal cancer (OC) among residents of the Eastern Cape Province of South Africa. The study was conducted on 670 incident cases (98/% response rate) and 1188 controls (96/% response rate) attending either of the three major referral hospitals in the Province, i.e Umtata General, Frere and Cecilia Makiwane Hospitals.
30
Essack, Magbubah. "Screening extracts of indigenous South African plants for the presence of anti-cancer compounds". Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8767_1210844967.
Testo completoAbstract (sommario):
Early man dabbled with the use of plant extracts to cure ailments. This practice has been passed down from generation to generation and today more than 50% of the world'sdrugs are natural products or derivatives thereof. Scientists have thus established a branch of research called natural product research. This branch of research involves the identification and purification of secondary metabolites with a specific biological activity. The methodology involves the screening of plant products for a specific biological activity, purification of the biologically active natural product by separation technology and structure determination. The biologically active natural products is then further scrutinized to serve as a novel drug or lead compound for the development of a novel drug. This research exploited this research methodology.
31
Habib, Sanzida Zohra. "South Asian immigrant women’s access to and experiences with breast and cervical cancer screening services in Canada". Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42855.
Testo completoAbstract (sommario):
A qualitative feminist study, informed by social constructionist epistemology, antiracist theories and intersectionality perspectives, was conducted in order to understand South Asian immigrant women’s access to and experiences with breast and cervical cancer screening services in Canada. Particular attention was paid to the wider context of their lives and their experiences of migration, resettlement, integration and general access to the Canadian healthcare system. The study also explored how the broader systems, structures and policies in Canadian society shape South Asian immigrant women’s participation in and access to cancer screening services. Thirty one South Asian immigrant women were interviewed in individual, couple and group settings in greater Vancouver. Research findings indicated that women’s age, length of stay since immigration, educational and generational status, not/having a family history or symptoms impact their use or lack of use of cancer screening services; but these factors also intersect in complex ways with various systemic and structural issues including not having a recommendation from physicians, women’s financial instability, access to income, employment, settlement services and community resources, levels of socioeconomic integration and familiarity with the Canadian healthcare system, and gender roles and responsibilities. Women’s narratives also showed that the immigration factor amplify the intersecting forms of inequities and the social determinants of health such as gender, class, poverty, racialization and discrimination, and affect women’s physical and mental health and access to healthcare services, cancer screening being one of them. An intersectional analysis revealed that the gendered and racialized immigration and integration policies, multicultural discourses and neoliberal ideologies and practices intersect to situate South Asian immigrant women into racialized and disadvantaged situations as the ‘other’ wherein access to preventive cancer screening services becomes especially challenging. South Asian women’s access to cancer screening and other healthcare services needs to be understood beyond the attempts to know their cultural health beliefs and practices, and beyond the neoliberal ideas of ‘self-care,’ ‘individual responsibility,’ ‘patient empowerment,’ and ‘culturally sensitive care.’ Also, equitable access to health care cannot be ensured without resisting these women’s racialized position as the ‘other’ and addressing the social, political, historical, material and structural inequities in Canadian society.
32
Prinsloo, Erna Louisa. "From victims to warriors: collective identity construction at cancer movement assemblies in South Africa". Doctoral thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16684.
Testo completoAbstract (sommario):
Includes bibliographical referencesInterest in this topic was awakened by the rapid growth of Relay For Life in South Africa and its striking ability to bond people during mass cancer gatherings. Questions were raised about the generation of collective identities during these assemblies, the nature of the activated identities, and how these relate to the broader debates about cancer and identity. This inquiry investigates the unexplored intersection of cancer and identity in the context of a burgeoning solidarity movement that has found a strong following countrywide. A contemporary hermeneutic perspective allowed a dual focus on the micro-sociological dimensions and the structural elements that converge to generate collective identities at assemblies. A theoretical scheme was synthesized out of the work of theorists who deal with collective identity, spaces set aside for people in crisis, social interaction during focused gatherings and illness narratives. A non-comparative case study was used to investigate the phenomenon at 20 cancer assemblies. Short-term ethnography, focus group interviews, photographs and YouTube videos provided the data that was analysed using the hermeneutic circle of interpretation. The findings showed that personal illness identities and situation-specific role identities interact with a potent cocktail of elements - ephemeral space, a shared focus on cancer, collective action, illusion and emotions - to activate three symbolic identities: a dominant collective identity that relies on heroic warrior mythology, a secondary collective identity that draws upon a transformation ideal, and a hidden identity which has its roots in the notion of being wounded. It is argued that assemblies rely on a dominant collective identity which is symbolic in nature and imposed on participants by the cancer movement. Participants are portrayed as positive, hopeful heroic warriors tasked with vanquishing cancer. Although ubiquitous at cancer assemblies, the dominant collective identity is nevertheless sufficiently fluid to allow a measure of hybridization, inversion and contestation. This inquiry gives credence to other work on cancer and identity which recognizes that the dominant identity provides benefits not offered by a victim representation. It also expresses reservations about the wisdom of expecting affected people to maintain a brave exterior in the face of an illness that causes emotional disequilibrium.
33
Abram, Muhammed Hanif. "The incidence of oral and oropharyngeal cancer in South Africa for the five year period 1997-2001". Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/24655.
Testo completoAbstract (sommario):
The National Cancer Registry (NCR) of South Africa publishes pathology-based cancer incidence in the country and is the main cancer data source. The data published by the NCR have been used extensively in the development of the draft national guidelines for cancer prevention and control as well as for cancer research. The list of contributing pathology laboratories is fairly inclusive. As far as Oral Cancer is concerned, the Department of Oral Pathology, University of Limpopo, has however not submitted data to the NCR. It is therefore reasonable to assume that because of this, a large proportion of histologically diagnosed oral cancers are not reflected in the NCR. Materials and methods: Data from the National Cancer Registry and the University of Limpopo, Department of Oral Pathology for the five years 1997-2001 were combined and then filtered for sites in the oral and oropharyngeal region. Age- Standardised Incidence Rates (ASIR) and the Cumulative Lifetime Risk (LR) for males and females in the different population groups were determined. Conclusion: It is possible that the total ASIR for oral and oropharyngeal cancer has increased in South Africa. The incidence of oral and oropharyngeal cancer in individuals below the age of 45 years in South Africa is higher than the global average.Dissertation (MChD)--University of Pretoria, 2013.
Oral Pathology and Oral Biology
unrestricted
34
Rambalee, Veneesha. "Effects of 2-methoxyestradiol, an endogenous estrogen metabolite, on SNO and WHCO3 oesophageal cancer cell growth". Diss., Access to E-Thesis, 2003. http://upetd.up.ac.za/thesis/available/etd-09272005-143729/.
Testo completo
35
Sibeko, Lindiwe Nobesuthu. "Acceptability and feasibility of heat-treated expressed breastmilk following exclusive breastfeeding by HIV-1 infected South African women". Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103386.
Testo completoAbstract (sommario):
Qualitative and quantitative research methods were employed to evaluate the acceptability and feasibility of HIV-1 infected, urban South African mothers being able to feed their infants heat-treated expressed breast milk (HTEBM). Nutritional status assessment of HIV-infected breastfeeding mothers (n=84) indicated that maternal status was not compromised; mean body mass index 26.8 (4.0) kg/m2, triceps skinfold 14.8 (5.50) mm and hemoglobin 11.6 (1.49) g/dL. However, severely immunocompromised mothers (CD4 + < 200 cells/mm3) were more likely to be anemic. Breastmilk viral loads were also higher in mothers with lower CD4+ cell counts. Community based inquiry on the acceptability of HTEBM was accomplished through in-depth interviews of participants (n=31), at the individual (mothers), family (partners, grandparents, mothers-in-law) and at the community level (traditional healers, daycare worker, health care counselors). Although an unfamiliar concept for all interviewed, overall, HTEBM was found to be an acceptable feeding choice regardless of respondents' gender, age, maternal status, family or community role. Further, data indicated mothers rarely received quality infant feeding counseling, consequently mixed feeding, a high risk for HIV transmission, was a common practice. In a pilot longitudinal study, using mixed-methods, the feasibility of mothers successfully implementing a modified breastfeeding intervention (6 months exclusive breastfeeding (EBF), cessation of breastfeeding, followed by use of HTEBM with complementary diet) was evaluated. The majority of mothers (36/66) practiced EBF for 6 months, 42% of whom also used HTEBM, expressing a range of approximately, 65 ml to 600 ml of breastmilk daily, for varying durations (2 weeks to 5 months). Mothers did not experience breast pathology. Home visits were highly enabling as was disclosure of HIV status to a partner. This is the first study to demonstrate that use of HTEBM is a feasible infant feeding option for HIV infected women. HTEBM may offer one solution to reduce vertical transmission of HIV and help maintain nutritional adequacy, as a component of complementary feeding.
36
Prodehl, Leanne. "Triple negative breast cancer in South Africa". Thesis, 2016. http://hdl.handle.net/10539/22459.
Testo completoAbstract (sommario):
MBChB FCS (SA) Cert GIT
Department of Surgery
University of the WitwatersrandThere were 275 patients with triple negative breast cancer identified out of 1898 patients (14.4%). The prevalence at Milpark Breast Care Unit was 13.9% and 16.1% at Helen Joseph Hospital. 135 patients were further analysed. Stage at presentation was IIa and IIb in approximately half (47.23%) of the patients. Patients presented with large tumours - 57.78% greater than two centimeters, and lymph node positive disease (55.55%). The majority (72.73%) of patients had high-grade, poorly differentiated tumours. This is consistent with studies showing that triple negative breast cancers present with more advanced tumours. There was a non-significant trend for younger patients to present with more advanced tumours with more aggressive histology. The triple negative breast cancer is challenging to manage due to its lack of response to steroid blockade and lack of biological therapy. This was reflected in the number of patients treated with multimodality therapy. 94.81% of patients had chemotherapy, 59.26% as neoadjuvant and 40.74% as adjuvant treatment. There were 93 (68.89%) patients treated with radiation therapy. There was a recurrence in 22.96% of patients, with preponderance to lymph node and visceral metastases. Recurrences occurred early, the median was 23.1 months and all had occurred within eight years. Younger patients had more recurrences (32.35%) and all occurred within six years. Stage at presentation and lymph node involvement were significantly associated with recurrence. Complete pathological response to neoadjuvant chemotherapy is associated with improved outcomes. The recurrence rate was 1.25% if there was a complete pathological response in both the breast and lymph nodes. The mortality rate was 19.26% and was greater in younger patients, 23.53% for women 40 years old and younger and 31.82% for women 35 years old and younger. Mortality was significantly associated with stage at presentation and lack of surgery but not lymph node positivity. Conclusion The prevalence of triple negative breast cancer in two South African breast care units was similar to some studies but less than studies in West and East Africa. Patients in these units, similar to other units, presented at a more advanced stage and had poorer outcomes than luminal breast cancers. Younger patients showed a trend to more advanced presentation and poorer outcomes than older patients within the triple negative subtype. This suggests than the outcomes of young patients cannot be explained by preponderance to aggressive subtypes alone.
MT2017
37
Bhana-Nathoo, Deepa. "Imaging features of triple negative breast cancer in a tertiary hospital in South Africa". Thesis, 2019. https://hdl.handle.net/10539/28176.
Testo completoAbstract (sommario):
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of
Master of Medicine in Diagnostic Radiology
Johannesburg, 2019INTRODUCTION Breast cancer is one of the leading causes of cancer deaths worldwide. Triple negative breast Cancer (TNBC) is an aggressive subtype, commonly described as presenting at a younger age, in women of African descent and in low socioeconomic groups. Commonly it demonstrates benign imaging features making diagnosis a challenge. Early detection and treatment is imperative. AIM To determine the common imaging features of TNBC in South Africa. METHOD A retrospective study was conducted at a tertiary institution in South Africa. the study population included all biopsy proven TNBC patients presenting between 01/01/2012 – 30/06/2016. All the initial mammograms were re-read by three independent radiologists using a data collection sheet. Illegible or incomplete reports were excluded from the study. RESULTS In our population, TNBC commonly presented in African women with an average age of 54.2 and range 25-95 years, with 47% being pre-menopausal. Typical mammographic features were an oval (27%) or irregular (27%) shaped mass with well circumscribed margins (33%). Our lesions were much larger than those reported in the literature (1). Global asymmetry and architectural distortion were commonly associated features. On ultrasound, the lesions were mostly irregularly shaped (56%) with spiculated borders (29%) and hypoechoic (80%) with axillary adenopathy (81%). CONCLUSION The majority of our patient population presented with a clinically palpable mass, that was larger and had more aggressive features than usually described in the literature. This can be attributed to delayed presentation, due to numerous factors. In order to improving the detection rate and reduce mortality, education and screening programs play a major role.
E.K. 2019
38
Van, der Wiel Renee. "Unravelling stereotype, unanticipated sociality : breast cancer treatment at a public healthcare facility in post-apartheid Johannesburg". Thesis, 2013. http://hdl.handle.net/10539/13184.
Testo completoAbstract (sommario):
This dissertation presents an ethnographic account of a socially diverse, public breast cancer clinic in Johannesburg. The findings of this qualitative research radically challenge the unproblematised and overdetermined use of the categories of race and gender in existing literature concerning this disease. The growing breast cancer epidemic in South Africa affects all demographic categories of women including young women. Yet, previous research frames this as a racialised and gendered crisis. Black women have been depicted as ignorant “problem patients” who resist biomedical treatment, and all women are described as having a particular relationship to their breasted bodies and a deep fear of mastectomy. Departing from these stereotypes, this ethnography reveals unanticipated data showing, firstly, that race, class, age and level of education did not determine women’s relationship to breast cancer and biomedicine. Secondly, socially diverse women commonly experienced breast cancer as a life-threatening disease that evoked confrontation with existential concerns regarding suffering, death, family, and faith. Due to these commonalities, an intimate and powerful sociality existed amongst women at this clinic. Thirdly, within this sociality, women accepted mastectomy as a necessity in creating a healthy body. Breastlessness was normalised and women generally were reluctant of breast reconstruction, thus destabilising the conceptual relationship between breasts and gender. This dissertation’s deconstruction of the use of hegemonic social categories is a significant intervention in a context where these categories are often viewed as absolute determinants of social and health phenomena, and therefore prompts more nuanced approaches to understanding experiences of illness in post-apartheid South Africa.
39
Langa, Bridget Cebisile. "Genomic instability in South African breast cancer patients". 2013. http://hdl.handle.net/11394/3600.
Testo completoAbstract (sommario):
Magister Scientiae (Medical Bioscience) - MSc(MBS)Breast cancer (BC) is one of the most common malignancies in women. Death results from treatment failure and metastatic disease. Thousands of lives might be saved if it was possible to detect and eliminate occult metastatic cells before they become clinically evident. Therefore, there is a critical need to identify new markers to improve treatment options for these patients. Genomic instability is the earliest indication of breast cancer and the use of genomic methodologies is a progress towards early detection and treatment, through the identification of biomarkers that can be translated into novel therapy targets. The interferon regulatory factor-1(IRF-1) gene, localized on chromosome 5q31.1, is believed to act as a tumor suppressor gene in breast cancer. The IRF-1 was found to be inactivated by single nucleotide polymorphism (SNP) in breast cancer suggesting that the loss of its function might be critical to the development of the disease. The phosphatidylinositol 3-kinase (PIK3) signaling pathway mediates key cellular functions and alterations of genes in this pathway, including PIK3CA, serine-threonine protein kinases (AKT1and AKT2), phosphatase and tensin homolog (PTEN), fibroblast growth factor receptor 2 (FGFR2) and ERBB2, whose expression have been demonstrated to be altered in breast cancer patients. In addition, these genes are linked to treatment resistance. vi In this study, we have investigated allelic loss of IRF-1 gene in primary tumors obtained from patients undergoing mastectomy at Groote Schuur hospital (Cape Town, South Africa). These samples were then further analyzed for the DNA copy number changes of specific genes involved in the PIK3/AKT signaling pathway. Statistical analysis has been performed in order to correlate genomic findings with clinical-histopathological and follow up information from the patients and to establish whether these genes can predict prognosis. Our data analysis has indicated that 46 cases (45.5%) out of 101 cases were informative for the IRF-1 dinucleotide marker used for LOH analysis (Figure 3.1). LOH was detected in 23 of these informative cases (23/46; 50%). No statistical significance was found between LOH at the IRF-1 locus and age (≤50 years or >50 years) (P value = 1.0000) and earlier stage (Stages I and II) (P value= 0.4982) based on Fisher’s exact test. Patients presented a high level of DNA copy number changes in genes involved in the PIK3/AKT pathway. The most frequent changes were observed in the PIK3CA and PTEN genes. PIK3CA presented high copy number in 36.8% of the cases. PTEN was observed with low copy number in 47.5% of the cases. This dissertation shows the effectiveness of genomic methodologies as means for the detection of early breast cancer progression in South African women. The PIK 3/AKT genes can validate the usefulness of breast cancer therapies.
40
De, Vos Cheryl Lisa. "Breast cancer in the Ashkenazi Jewish population of South Africa: some psychosocial issues". Thesis, 2014.
Cerca il testo completoAbstract (sommario):
Specific mutations in the breast cancer susceptibility genes 1 and 2 (BRCA1 and BRCA2) have been found to be the cause of breast cancer (BRCA) in about 20% of cases in the Jewish population. Affected women often experience a variety of emotional and social issues, which need to be addressed. The aim o f this study was to investigate some
o f the psychosocial issues associated with BRCA, the knowledge o f and feelings about it,
its treatment and screening strategies, and attitudes to genetic testing in Ashkenazi Jewish women. The subjects were women aged > 18 years with BRCA (30 subjects, Group A),or who had an affected first-degree relative (FDRs) (9 subjects, Group B), or without a family history of BRCA (30 controls, Group C). They were ascertained from the Genetic Counselling files held at the South African Institute for Medical Research (SAIMR), the Medical Oncology Centre o f Rosebank, Johannesburg, the Reach for Recovery organisation, the patient network, or, in the case o f the controls, from the records of the Union of Jewish Women (UJW). A schedule o f questions was specifically constructed (and checked in a pilot study) for use in this study and the Beck Depression Inventory (BDI) was selected to measure depression. A face-to-face interview was conducted with each subject and the schedule and BDI were completed. The average age of the subjects was 57 years, 36 years and 52 years in groups A, B and C respectively. The average age o f Group A subjects at diagnosis was 48.7 years and all had had surgery. The subjects' knowledge of the genetics of BRCA scored between moderate and good. Many Group B subjects overestimated the lifetime risk of developing BRCA. Almos. half (46.7%) the Group A women reported shock as the dominating emotion after diagnosis and they were very concerned that their children would develop the condition (43.3%) or that the cancer would metastasise (26.7%). Only 13 (26.5%) of the medical practitioners involved in the care of the Group A subjects in this study discussed emotional issues with their patients.The group B subjects, after the diagnosis was made in a relative, reported fear of developing BRCA (5), fear o f dying o f the disease (5), and feeling out of control (4).Most subjects (87%) felt that women with BRCA and their relatives would benefit from professional counselling. Less than 25% of subjects in all groups undertook regular breast self-examination (BSE), but one-third of group A subjects discovered a lump themselves.Medical practitioners recommended mammograms in older women to all Group B subjects and most (76%) o f the Group C subjects. However, regular CBE and BSE were only recommended rarely. Half the Group A and Group B subjects stated that they would request genetic testing if it were available locally, mostly to determine whether their children were at risk, or, in the case of FDR's, whether they should improve their vigilance. In order for holistic treatment to be given to affected women and their relatives’ psychosocial and genetic counseling issues should be addressed. Also, the findings suggest that women require further education on the importance o f using available screening strategies for the condition and on the possibility o f genetic testing for BRCA susceptibility in high-risk families. However, such testing needs to be carefully supported and monitored to prevent or ameliorate any adverse psychological or social responses.The study has given an insight into the knowledge of BRCA genetics, the emotional burden, and attitudes to screening and testing possibilities, associated with BRCA in the local Ashkenazi Jewish population.
41
Choene, Mpho Susan. "Evaluating the effect of South African Herbal extracts on breast cancer cells". Thesis, 2013. http://hdl.handle.net/10539/12362.
Testo completoAbstract (sommario):
In this research we aimed to investigate the anti-proliferative properties of three South African plants: Kedrostis foetidissima, Euphorbia mauritanica and Elytropappus rhinocerotis against breast cancer cells. This was done on the basis of their documented ethno-medicinal use against cancer and other ailments. The plant extracts were screened for cytotoxicity and pro-apoptotic activity against two breast cancer cell lines MCF-7 and YMB-1. With an IC50 ~ 100 μg/ml, K. foetidissima was the only extract that exhibited significant cytotoxicity on both cell lines, whilst E. mauritanica was cytotoxic to MCF-7 cells only. The cytotoxicity assay was followed by the Annexin-V detection assay to evaluate the occurrence of apoptosis. The results observed suggested that K. foetidissima was inducing significant apoptosis on both YMB-1 and MCF-7 cells, whilst E. mauritanica was inducing significant apoptosis on MCF-7 cells.
Since both K. foetidissima and E. mauritanica crude extracts induced apoptosis to MCF-7 cells, they were selected for gene expression studies on MCF-7 using real-time PCR. This was done with the aim of investigating if these extracts were having an effect on the tumour suppressors p53 and RBBP6, which were shown in previous studies to be deregulated in up to 50% of cancers. From the real-time PCR data we observed no changes in the expression levels of these genes following treatment with the herbal extracts. This may suggest that these plants have an effect on other components of the apoptotic pathway other than the tumour suppressors p53 and RBBP6.
The antiproliferative activity observed whilst treating these particular cell lines with K. foetidissima and E. mauritanica suggests that these South African herbal plants present themselves as potential future cancer therapeutic agents; however, further studies on these herbal plants need to be performed to validate these results.
KEYWORDS: Apoptosis
Breast cancer
Euphorbia mauritanica
Kedrostis foetidissima
p53
42
Moodley, Louise Claire. "Existential reflections of South African women with breast cancer". Thesis, 2012. http://hdl.handle.net/10539/11327.
Testo completoAbstract (sommario):
The period following a breast cancer diagnosis has been described as a time of reflection and
inward search for existential meaning. The purpose of this study was to explore how South
African women dealt with suffering, the possibility of death and found meaning in their diagnosis
and ensuing treatment and its termination. This sample comprised of eight South Africa women
between the ages of 30 to 57 years, diagnosed with breast cancer, and who had terminated active
oncology treatment. The design of the study was qualitative. Semi-structured interviews were
utilised to examine the existential issues facing the respondents. The data was analysed using
Patton’s principles of Thematic Content Analysis (1987) which reduced the narratives into three
key themes namely: existential reflections, existential meaning and role of culture. Physical and
emotional suffering was experienced as an outcome of participants’ treatment and ensuing
circumstance. This suffering was understood as the price that one must pay in order to survive
cancer and thus most participants assigned positive connotations to treatment in order to ascribe
meaning. As treatment affected every aspect of participants’ lives, there was a need to greatly
revise and re-evaluate ones’ values and purpose in life. In addition, participants expressed deep
regret and guilt over the manner in which they had lived their lives before their diagnosis. This
seemed to initiate a bargaining process which resulted in more intrinsically fulfilled women.
Participants seemed to engage in many strategies in order to defeat their cancer and continue on
with their lives; these strategies were mainly controlled by hope and positivity. This was greatly
associated with the meaning participants made from their experience. Two predominant elements
were utilised to make meaning: religion and spirituality, and purpose in life. There seemed to be
an interconnectedness between helping others and helping oneself that was derived from
spirituality and religion and ones’ perceived purpose in life. All aspects of meaning making and
adjustment seemed to heavily influence by one’s cultural affiliations and beliefs. From this study,
it is evident that South African women engage in meaning-making activities and successfully
negotiate these in order to achieve meaning and adjustment to having breast cancer. This research
suggests that once a comprehensive understanding is developed of the range of existential
concerns that South African women experience, we will be better able to provide resources that
are more adequately suited to assist with their experienced difficulties and this may result in
improved levels of adjustment and quality of life
43
Abrahams, Odette Natasha. "Occupations and breast cancer in women treated at a tertiary hospital in Johannesburg". Thesis, 2015. http://hdl.handle.net/10539/17428.
Testo completoAbstract (sommario):
Submitted a requirements for the degree of Master of Medicine in the branch of Community
Health (Occupational Medicine). It has not been used, either wholly or partially, for any
other degree or examination at this or any other university.Introduction This is the first study in South Africa to look for an association between breast cancer and occupations in black women. Breast cancer is one of the commonest forms of malignancy experienced by women in South Africa and its incidence is increasing (1). Approximately six million women work in South Africa, some of these women are likely to be exposed to carcinogenic agents during their daily working lives. Many occupational carcinogens to the breast have been described and there is some evidence suggesting that many more synthetic chemicals used in different industries may also have carcinogenic properties that have not fully been explored as yet (2). This study plans to identify occupations that place black women at risk of breast cancer in the South African context. Thereafter, it will assess if there is an association between shift work (a known carcinogen to the breast) and breast cancer in black women in South Africa. The findings of the study could be of particular significance to the local context, given that women are entering the workforce in increasing numbers possibly putting more women at risk. Aims The aims of the study are to identify occupations that possibly increase the risk of breast cancer in South Africa, and to specifically assess if there is an association between shift work and breast cancer in black South African women. Objectives To determine whether there are associations between different occupations and breast cancer in black women by calculating the odds ratios (ORs) for breast cancer in different occupations in South Africa. To examine the association between shift work and breast cancer in black women adjusting for variables that may confound the association. Methods The study is an unmatched case-control study using secondary data from the existing Johannesburg Cancer Case Control Study (JCCS) database. The JCCS study is a large ongoing study that recruits black male and female cancer patients with all types of cancers receiving treatment at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), a tertiary hospital in Johannesburg. All women patients recruited from 1 January 2001 to 31 December 2009 were included in the analysis. This included 1 903 cases and 3 990 controls. An expert group was set up to estimate the likelihood of occupational engagement in shift work for the existing occupational groupings present in the JCCS database. These occupations were classified into: a) high probability of shift work; b) possibility of shift work and c) unlikely to do shift work. ORs were estimated using logistic regression. Those who had never worked were the reference category. Bivariate analysis was then carried out to estimate ORs between individual occupations and breast cancer and later to estimate ORs between the likelihood of involvement in shift work and breast cancer. Multivariate logistic regression followed a forward stepwise approach and all the possible confounders present in the JCCS database were considered. These included age, smoking, drinking alcohol, age at first menarche, parity, age at menopause, use of oral contraception and retroviral status. Results With regards to occupation, the bivariate analyses showed significant ORs for breast cancer in the occupational categories of health, education, social services, retail, hospitality, construction, food, textile and manufacturing, with the highest OR in education (OR 2.33, 95% CI: 1.44 – 3.78) and social service (OR 2.39, 95% CI: 1.24 – 4.58) followed by office workers (OR 2.17, 95% CI: 1.47-3.20) and health workers (OR 2.01, 95% CI: 1.33-3.04). Agriculture (OR 0.55, 95% CI: 0.32 – 0.94) and domestic workers (OR 0.96, 95% CI: 0.75 – 1.22) had ORs under one. Following the adjustments for possible confounders, no statistically significant ORs were found between specific occupations and breast cancer. However, manufacturing had the highest OR (OR 1.44, 95% CI: 0.42- 4.94), followed by office workers (OR 1.44 95% CI: 0.31- 5.94) and health workers (OR 1.31, 95% CI: 0.36-4.76) as compared to the never worked group. In the bivariate analyses there was an association between a possibility of doing shift workers and breast cancer (OR 1.66, 95% CI: 1.41-1.97). Similarly, women who had a high likelihood of participating in shift work had an elevated odds ratio for the disease (OR 1.76, 95% CI: 1.44-2.15). After adjusting for confounders in the multivariate model the ORs for both shift work groups were increased with women who possibly did shift work having an OR of 2.18 (95% CI: 1.34- 3.56) and those who had a high likelihood of carrying out shift work having an OR of 2.13 (95% CI: 1.26- 3.61). Conclusions The bivariate analyses identified elevated ORs for breast cancer in some occupations but in multivariate analyses no statistically significant OR were found. Nevertheless ORs>1 were found for the occupational categories of manufacturing, office and health workers. This study reports a strong association of breast cancer and shift work, which is supported by the literature. However shift work still remains necessary for the functioning of many industries. Many gaps still exist, however, and this study has tried to address one of the neglected areas of occupational risks for breast cancer development.
44
Singh, R. "The relationship between stressful life events, locus of control and the onset of breast cancer". Thesis, 2012. http://hdl.handle.net/10210/6745.
Testo completo
45
Mertz, Magaretha Susara. "Quality of life in patients with metastatic breast cancer : A South African perspective". Thesis, 2000. http://hdl.handle.net/2263/28399.
Testo completo
46
Mdondolo, Nosipho. "Cultural factors associated with management of a breast lump amongst Xhosa women". Diss., 2002. http://hdl.handle.net/10500/609.
Testo completoAbstract (sommario):
A qualitative research design and an ethno-nursing research method were used to identify cultural factors influencing Xhosa women's health seeking behaviours associated with breast lumps. Focus group interviews were conducted to obtain data.
The research results revealed that these Xhosa women with breast lumps did not disclose some cultural factors which influenced their health seeking behaviours associated breast lumps. Registered nurses, sharing the same culture and language as the Xhosa women, revealed that Xhosa women with breast lumps sought treatment from traditional healers, prior to seeking medical care from the hospital and/or clinics. When they arrive at the hospital/clinics the breast lumps have often progressed to advanced ulcerated breast cancer, with poor prognoses and poor treatment outcomes.
Xhosa women lacked knowledge about the management of breast lumps. Health promotion efforts should address this issue at Primary Health Care services in the Eastern Cape.Health Studies
M.A. (Health Studies)
47
Levin, Debra. "Team-patient communication of information and support at the Breast Cancer Clinic of the Johannesburg Hospital". 1997. http://hdl.handle.net/10500/17206.
Testo completoAbstract (sommario):
This study addresses the effectiveness of communication between the team (doctors, sisters and social workers) and patients at the Breast Cancer Clinic of the Johannesburg Hospital. Tue needs of patients were highlighted, as well as the role of care-giver, both as a group and in their separate disciplines, in attempting to meet these needs. Tue empirical survey was carried out through the use of questionnaires as well as interview schedules. Patients, doctors, nurses and social workers were used as respondents. Results indicated that the majority of patients' needs for information and support were met by the team in general; however, a need for further social work intervention seemed to be apparent. In addition, several barriers were found to inhibit both team-patient and inter-team communication. Tue researcher used the information gathered in this study to make recommendations that will facilitate improved communication in the clinic, with specific reference to the role of the social worker.Social Work
M.A.(Social Science: Mental Health)
48
Herd, Olivia Jayne. "Analysis of radiosensitivity in South African cervical and breast cancer patients". Thesis, 2015. http://hdl.handle.net/10539/18487.
Testo completoAbstract (sommario):
Introduction: Ionising radiation can cause DNA double strand breaks (DSB), that result in chromosomal aberrations if un- or mis-repaired. Individuals with compromised DNA damage repair mechanisms display increased chromosomal radiosensitivity. The G0-micronucleus assay (MN assay) and the γ-H2AX assay are two assays used in radiobiology to study DNA DSB and repair.
Breast cancer is the leading cancer amongst South African women, with a lifetime risk of 1 in 34. Since most cancer patients in South Africa present with late-stage disease, chemotherapy and radiotherapy are commonly-used treatments. Several international studies have shown breast cancer patients to be more chromosomally radiosensitive than healthy controls. These studies have not been confirmed on a cancer population living in South Africa.
Cervical cancer is the second most common cancer in South Africa; however, it is the leading cancer amongst black women with a lifetime risk of 1/35 compared to 1/82 in white women. Studies show a genetic link to cervical cancer susceptibility and DNA damage repair genes. International studies on radiation-induced DNA damage in lymphocytes of cervical cancer patients remain inconclusive and have never been performed on a South African population. Cervical cancer is caused by infection with the Human Papilloma Virus (HPV). Human Immunodeficiency Virus (HIV), HPV and cervical cancer are epidemiologically linked. Due to the high rate of HIV in South Africa, a significant proportion of cervical cancer patients receiving radiotherapy treatment will be HIV-positive. Studies show an effect of HIV on chromosomal radiosensitivity, however this has not been confirmed on a cancer population. The MN assay on the biopsies and exfoliated cervical cells of cervical cancer
49
Kaloianova, Maria Simeonova. "Imaging features of male breast cancer in a South African population". Thesis, 2017. https://hdl.handle.net/10539/24861.
Testo completoAbstract (sommario):
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Diagnostic Radiology
Johannesburg, 2017.INTRODUCTION: Male breast cancer is a very rare entity, representing less than 1% of all cancers affecting men (1, 2). Only 0.7% of all breast carcinomas are attributed to male breast cancer (3). As a result, there is little published data worldwide and especially from South Africa about the imaging features of breast malignancy in men. This study looked at the mammographic and ultrasound features of male breast cancer in the South African context. AIM: To describe the imaging features of male breast cancer in a South African population. METHOD: The histological reports of all patients who met the inclusion criteria were extracted from the National Health Laboratory Services (NHLS) patient records database and printed. The demographic data was used to trace the relevant diagnostic imaging studies that were performed for each patient. Only the mammography and ultrasound reports were reviewed, images were not re-reviewed. RESULTS: Seventy-six patients between the ages of 31 to 89 with confirmed primary breast malignancy were found in the NHLS database for the predetermined eleven-year period. Only 20 of the 76 had imaging reports available for assessment. Thirty-five percent of malignant lesions demonstrated microcalcifications, while 20% were spiculate, 20% irregular and 25% macrolobulated. On ultrasound, only 35% of lesions were hypoechoic with 20% demonstrating posterior acoustic shadowing. Invasive ductal carcinoma represented 91% of all primary male malignant breast lesions in our study population, with 8% of lesions attributed to invasive papillary carcinoma and only 1% ductal carcinoma in-situ. CONCLUSIONS: Male breast cancer in South Africa is similar to male breast cancer elsewhere, not only on imaging but also on histology and immunohistochemistry.
LG2018
50
Moukangoe, Phaswane Isaac Justice. "The association of night-shift work with the development of breast cancer in women". Diss., 2013. http://hdl.handle.net/10500/14143.
Testo completoAbstract (sommario):
Breast cancer poses a serious public health concern. This case-control study
describes the relationship of night-shift working on the development of breast cancer
in 57 women diagnosed with breast cancer compared to 49 women with other types
of cancer in the Vaal Triangle area (selected through non-probability purposive
sampling from CANSA). The study revealed that women who work night-shift
developed breast cancer 1.24 times more often than women who do not work nightshift
(OR=1.24 [95% CI 0.52 to 2.89]). The odds ratio was further increased in
women who worked rotating-shift (OR=1.44 [95% CI 0.58 to 3.59]). Night-shift work
exposure was not statistically related to the development of breast cancer. It is
recommended that the relationship between night-shift exposure and breast cancer
risk be further explored through cross-sectional and cohort studies, and other breast cancer pathways.Health Studies
M.A. (Public Health)