title: Metastatic breast cancer in a Nigerian tertiary hospital.
abstract: BACKGROUND
  Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome.
  
  
  OBJECTIVE
  To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital.
  
  
  METHODS
  Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were reviewed.
  
  
  RESULTS
  More than half of all histologically confirmed breast cancer patients seen within the study period presented with metastatic disease. Their ages ranged between 20-81 years with a mean age of 45.9 years. Only 3% (6 of 202) were males. Two-thirds had more than one secondary site on initial evaluation and the commonest sites were liver (63%), lung parenchyma (51%), pleura (26%) and contralateral breast in 25%. On immunohistochemistry, basal like tumours were found in 46.1%. Mastectomy was done in 37 patients with fungating breast masses while only one third of those referred to a nearby center for radiotherapy had it done. One year survival rate was 27%.
  
  
  CONCLUSIONS
  Metastatic disease is common in Nigeria and treatment is limited due to resource limitations. Improved awareness of the disease is advocated to reduce late presentation.
authors.affiliation: Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. wadisc@yahoo.com
authors.forename: A O
authors.initials: AO
authors.lastname: Adisa
authors.forename: O A
authors.initials: OA
authors.lastname: Arowolo
authors.forename: A A
authors.initials: AA
authors.lastname: Akinkuolie
authors.forename: N A
authors.initials: NA
authors.lastname: Titiloye
authors.forename: O I
authors.initials: OI
authors.lastname: Alatise
authors.forename: O O
authors.initials: OO
authors.lastname: Lawal
authors.forename: A R K
authors.initials: AR
authors.lastname: Adesunkanmi
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D018295:Neoplasms, Basal Cell / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D009549:Nigeria / Q000453:epidemiology; D011878:Radiotherapy; D017678:Sex Distribution; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult