title: How Effective is the Treatment of Locally Advanced and Metastatic Breast Cancer in Developing Centres?: A Retrospective Review.
abstract: BACKGROUND
  The use of chemotherapy in advanced metastatic breast cancer remains a subject of controversy. The thought of MicKinnon et al (early 1950s) that the course of breast cancer was unaffected by chemotherapy has been refuted by results of treatment in the developed countries. The poor result of treatment in developing centres still compares with prechemotherapy era. Consequently, The McKinnon's thought may still lurk. We compared the survival of chemotherapy treated with chemotherapy untreated cancer of breast patients.
  
  
  METHODS
  Records of breast cancer patients who presented and died between January 2010 and May 2014 were reviewed. The primary outcome was overall survival. Records of patients that received chemotherapy with or without other tumor directed specific therapy were compared with records of patients who did not receive any tumor directed therapy.
  
  
  RESULTS
  Thirty-one patients received chemotherapy while 25 patients did not. All were females, more than 90% were of the patients had advanced or metastatic disease. Treatments were not biologically directed and treatment plans were largely compromised and suboptimal. The overall mean survival was 19.2 ±9.2 months, and the median duration was 17.5 months(range 6-44months). The overall survival was not statistically different between the two groups (p= 0.230, unequal variance assumed). The objective of using neoadjuvant chemotherapy for fungating lesions was not achieved.
  
  
  CONCLUSIONS
  In advanced and metastatic breast cancer, outcomes of patients who receive suboptimal regimen of cytotoxic chemotherapy do not differ from chemotherapy untreated patients.
authors.affiliation: Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Kwara State, Nigeria.
authors.forename: Agodirin
authors.initials: A
authors.lastname: Olayide
authors.affiliation: Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Kwara State, Nigeria.
authors.forename: Olatoke
authors.initials: O
authors.lastname: Samuel
authors.affiliation: Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Kwara State, Nigeria.
authors.forename: Rahman
authors.initials: R
authors.lastname: Ganiyu
authors.affiliation: Department of Surgery, Ladoke Akintola University of Technology and Ladoke Akintola Univeristy of Technology Teaching Hospital Ogbomoso, Oyo State, Nigeria.
authors.forename: Adeoti
authors.initials: A
authors.lastname: Moses
authors.affiliation: Department of Statistics, Unversity of Ilorin, Kwara State, Nigeria.
authors.forename: Oyeyemi
authors.initials: O
authors.lastname: Gafar
authors.affiliation: Pain and Palliative Unit. University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria.
authors.forename: Durojaiye
authors.initials: D
authors.lastname: Abiola
authors.affiliation: Department of Surgery, Ladoke Akintola University of Technology and Ladoke Akintola Univeristy of Technology Teaching Hospital Ogbomoso, Oyo State, Nigeria.
authors.forename: Kolawole
authors.initials: K
authors.lastname: Dapo
authors.affiliation: Ekiti State University, Ekiti State, Nigeria.
authors.forename: Agboola
authors.initials: A
authors.lastname: John
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003906:Developing Countries; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents
keywords: breast cancer; chemotherapy; suboptimal treatment; untreated