ISSN: 2689-8020
Authors: Ganiyu B Sikiru*, Felicitas U Idigo and Dambele M Y
Breast cancer is the commonest female cancer in developed and developing country with 55% occurring in developing country. The estimated number of new cases each year is expected to rise from 10million in 2002 to 15million by 2025 with 60% of those cases in developing countries. Breast cancer survival rate has been found to be 10% and 85% in Nigeria and United State of America respectively. Cancer can develop at any stage in life. It may take a year or more before a growing tumor (benign or malignant) can be detected, either on physical examination or on an investigating procedure. Breast cancer is the most common non-skin type of cancer and the second leading cause of cancer mortality in women. It is also the principal cause of death from cancer among women globally. Breast Cancers in females formed larger percentage of patients undergoing whole body scintigraphy in nuclear medicine for diagnosis and monitoring of the disease progression following surgery, radiotherapy and chemotherapy treatments. Breast cancer is commonly seen in four stages that represents its progression. A study conducted in University College Hospital found that Two hundred and twenty eight (44.0%) had disease on the right side, 253(48.8%) had disease on the left side while 37 (7.2%) had bilateral breast disease. Immunohistochemistry (IHC) is a special staining process performed on fresh or frozen breast cancer tissue removed during biopsy. IHC is used to show whether or not the cancer cells have Human Epidermal Growth Factor Receptor 2 (HER-2) and/or hormone receptors on their surface. Most testing laboratories use the IHC test to see if there are hormone receptors on breast cancer cells. If hormone receptors are present, this means that the cancer cells’ growth is fueled by the hormones estrogen and/or progesterone. Therefore the aim of this study is to correlate the bone scintigraphy findings with immunohistochemistry and clinical diagnosis/ management of female breast cancer patients. This study adopted a Cross-sectional prospective design. The study was conducted at the University College Hospital located at Queen Elizabeth road, Oritamefa, Ibadan North local government, Ibadan Area, Oyo State, Nigeria. The study population included female breast cancer patients managed in Surgical Outpatient unit of University College Hospital (UCH) Ibadan who were sent for bone scintingraphy in Nuclear Medicine, had immunohistochemistry test and are being treated at radiation oncology between November, 2016 and December, 2017. Data was analyzed using Descriptive statistics. The study showed that the age range of 35-44years had the highest frequency amounting to 33.3% followed by 45-54 age range with 28.2% (n=11). This shows how this disease affects the active and productive age group of female of child bearing age. It is worthy to note that breast cancer also occur in the elderly of 75years and above with just 2.6%. It shows that cancer of right breast (CRB) had the highest frequency of 57.9%. The Cancer of left breast (CLB) had 39.5% while only one patient had breast cancer on both the right and left breasts (bilateral) equivalent to 2.6%. This study generally showed that patients presented late and that most breast cancer deaths are due to advanced cancer, diagnosed when metastases have already disseminated to lymph nodes or distant organs. This also study depicts that larger percentage of breast cancer patients are not benefiting from immunohistochemistry as those referred were not many as indicated in the used sample size against total bone scan attended to and immunohistochemistry results. This study showed that there is a significant negative relationship between immunohistochemistry and bone scan result (r -0.732), Clinical diagnosis (r = 0.820 which is positive) and treatment of breast cancer (r = -0.538 which is negative). This means that the treatment does not agree with the IHC and CD, hence the treatment adopted could have been different in consideration to IHC. Therefore this study showed that bone scintingraphy is a vital tool in diagnosis and monitoring of breast cancer treatment. This study has demonstrated the need for more advocacies for early breast cancer detection, presentation to hospital, early request for IHC, bone scan and consideration in treatment so as to guide better breast cancer management and response to treatment.
Keywords: Bone Scintingraphy; Immunohistochemistry; Pre-Cancerous; Chemotherapy
