Breast Cancer in Nigeria: Diagnosis, Management and Challenges

Worldwide, breast cancer is the commonest cancer in women and it is characterized by regional variations and late clinical presentation and poor access in low and middle income countries including Nigeria. It is disproportionately responsible for mortality among women in developing countries compared to those in developed countries. There are several challenges associated with the effective management of breast cancer in Nigeria; financial barriers limit womens access to screening and treatment services, late-stage presentation, high incidence of triple negative breast cancers and failure in stewardship by government in their inability to provide the best possible cancer care like their counterparts in the West. There is an urgent need to step up activities through governmental and non-governmental agencies to promote advocacy, national policy on training of personnel for diagnosis, clinical and self-breast examination and nationwide screening program (mammography) in order to enhance early detection, control the upward trends and reduce the mortality rate associated with breast cancer. Routine age appropriate and specific breast screening should become an integral part of healthcare system in Nigeria allowing for early detection and intervention; aggressive awareness campaign on the advantages of early diagnosis and the dangers of late presentation, need to offer universal and affordable treatment, implementation of a strategy to offer annual mammogram to women above the age threshold for breast cancer, increased budgetary allocation for the diagnosis and management of cancer, more investment in the training of healthcare workers involved in the diagnosis and management of breast cancer, provision of Health Education encouraging women to conduct routine Breast Self Examination (BSE). BSE could become a simple, low-priced, secure, effective, appropriate and feasible screening tool in Nigeria. There is need to re-emphasize the importance of prompt reporting of any new breast symptoms to a health professional. Clinical Breast Examination (CBE) should become part of a periodic health examination, preferably at least every three years. Asymptomatic women aged 40 and over should be offered a CBE as part of a periodic health examination, preferably annually. Objective implementation of these steps can help reduce the incidence of breast cancer-related mortality in Nigeria.