title: Breast cancer diagnosis in a resource poor environment through a collaborative multidisciplinary approach: the Kenyan experience.
abstract: BACKGROUND
  The majority of women with breast cancer in Kenya present with node-positive (stage II) or locally advanced Q7 disease (stage IIIB). Diagnosis is made on fine needle aspirate cytology and treatment is with surgery if resectable. Diagnostic core biopsy is available only at subspecialty hospitals. Processing and reporting of biopsy tissue are not standardised. Hormone receptor and HER2 analyses are rarely done preoperatively.
  
  
  METHODS
  As part of a larger study investigating the prevalence of triple negative breast cancer in Kenya, a multidisciplinary workshop of collaborators from 10 healthcare facilities was held. Process gaps were identified, preanalytic variables impacting on ER/PR/HER2 discussed and training in core biopsy provided. Local remedial strategies were deliberated.
  
  
  CONCLUSIONS
  We describe our experience and outcome from the workshop, which can be modelled for other resource poor settings.
authors: Department of Pathology, Surgery and Radiology, Aga Khan University Hospital Nairobi, Nairobi, Kenya. shaheen.sayed@aku.edu
authors: Shahin
authors: S
authors: Sayed
authors: Zahir
authors: Z
authors: Moloo
authors: Peter
authors: P
authors: Bird
authors: Ronald
authors: R
authors: Wasike
authors: Wambui
authors: W
authors: Njoroge
authors: Joseph
authors: J
authors: Karanu
authors: Ancent
authors: A
authors: Nzioka
authors: Omar
authors: O
authors: Sherman
authors: Satya
authors: S
authors: Prasad
authors: Costa
authors: C
authors: Mariwa
authors: James Obondi
authors: JO
authors: Otieno
authors: David
authors: D
authors: Chumba
authors: David
authors: D
authors: Koech
authors: Daniel
authors: D
authors: Mbinga
authors: Musa
authors: M
authors: Mohammed
authors: Richard
authors: R
authors: Njoroge
authors: Rajendra
authors: R
authors: Chauhan
authors: Sudhir
authors: S
authors: Vinayak
authors: Catherine
authors: C
authors: Kyobutungi
authors: Mansoor
authors: M
authors: Saleh
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle / Q000592:standards; D001943:Breast Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000191:economics / Q000473:pathology / Q000601:surgery; D019411:Clinical Laboratory Techniques / Q000191:economics / Q000592:standards*; D003299:Cooperative Behavior; D003906:Developing Countries / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007150:Immunohistochemistry / Q000592:standards; D033183:Interdisciplinary Communication; D007630:Kenya; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010348:Patient Care Team / Q000191:economics; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human