dc.description.abstract | Study background: Bilateral breast cancer is an infrequent finding in our setup. As such, not
many studies have been carried out on this. The information gathered from this study will be
used to guide on management of such patients, prognosticate the outcome and even guide on
follow up based on the frequency, prognosis, histological and immunohistopathological features,
and therapeutic modalities.
Broad objective: To determine the burden and clinical-pathological characteristics of Bilateral
Breast Cancer at the Kenyatta National Hospital over a five-year period.
Study design and Site: This was a descriptive retrospective study covering a period of five
years which coincided with the existence of the breast MDT at K.N.H. The study was conducted
at K.N.H. , this being a national referral hospital that attends to many breast cancer patients. It is
a better representation of the disease burden and likely outcomes can be reached due to the
diversity of patients seeking treatment at K.N.H. It also serves as the teaching hospital for the
UoN, Faculty of Health Sciences, for both the undergraduate and postgraduate programs.
Materials and Method: Data from medical records of patients who had been treated for bilateral
breast cancer for the past five years at K.N.H. was retrieved. The data points were on the
demographic findings, family history, treatment modalities, staging, histopathology, and
immunohistochemistry.
Data Management: Data was checked for completeness and accuracy prior to entry into the
Microsoft Excel Spreadsheet, thereafter, transferred to the SPSS version 23 for analysis. If the pvalue
of a statistical test is found to be lower than 0.05, it was be considered substantial. Where
applicable, the odds ratios and their corresponding 95% confidence interval were reported.
Expected main outcome measure (Utility of the study): This study’s results will stimulate the
process of developing guidelines on management of patients with bilateral breast cancer in our
setup.
Results: The study obtained 29 files for the period of five years (2017-2021). Eight files were
excluded due to missing data and relevant information. The fourth decade was the most affected
period with a mean age of forty-two years. It took approximately 24 months from time of
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diagnosis to development of contra lateral tumor. Metachronous tumors were the commonest at
71.4% while synchronous tumors were 28.6%. Invasive ductal carcinoma was the only
carcinoma detected and the larger the primary tumor the more the chance of developing contra
lateral breast malignancy (>5cm higher risk). Nodal involvement did not have a direct correlation
with development of BiBc. Patients with BiBc frequently presented with distant metastasis to
other organs as compared to when the tumor was unilateral and immunohistochemistry of both
tumors was similar for all the patients.
Conclusion: Bilateral breast malignancy is an uncommon entity in our setup occurring mostly
in the fourth decade of life with an average diagnostic period of two years from time of primary
breast cancer diagnosis. Risk factors include age, patients with stage three and four tumors and
invasive ductal carcinoma diagnosis on pathology. Bilateral breast malignancies carry a higher
risk of metastasis to other organs and close follow up is warranted. Since immunohistochemical
markers appear to be similar between primary malignancy and the contra lateral malignancy,
there needs to be a revision in terms of treatment as there is a chance that both tumors share
similar histopathological aspects. | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |