Abstract:

Background: Breast cancer is one of the common malignant tumors in the world and is one of the leading causes of death due to cancer in women. The treatment of breast cancer in sub-Saharan Africa is largely limited to surgery because of advanced stage at presentation and limited access to diagnostic imaging as well as adjuvant therapy. The short term outcomes of surgical treatment of breast cancer in our environment are not scientifically known since there is no study that has been conducted about the topic. This study aimed to determine the short-term outcomes of surgical treatment of breast cancer and their predicting factors at Bugando Medical Centre (BMC).

Methods: This a prospective longitudinal study involving patients undergoing breast cancer surgery at Bugando Medical Centre from April 2021 to June 2022. In this study the predictors were patients’ characteristics, clinic-pathological characteristics and surgical characteristics whereas the outcomes were the short term postoperative complications, length of hospital stay and mortality.

Results: A total of 110 patients were studied. Their median age at presentation was 47 years. Majority of patients presented late with stage IV disease (46.4%) followed by stage III (30.9%) modified radical mastectomy was the most frequent surgical procedure performed in 83(75.5%) patients. Complications mainly surgical site infections were reported in 23.6% of cases and it’s was associated with pre-morbid illness (OR 0.19; 95% CI 0.052-0.76; p=0.019), duration of illness (>3 months) (OR 3.21; 95% CI 1.86-12.05; p=0.035) and duration of surgery (OR 2.11; 1.02-8.42; p=0.015). The overall median length of hospital stay (LOS) was 8 days. The presence of distant metastasis (OR 5.33; 95% CI 2.14-13.28; p=0.001) and complications (OR 0.014; 95%CI 0.002-0.080; p < 0.001) were significantly associated with LOS. There was no death.

Conclusion: This study has demonstrated that breast cancer surgery at Bugando Medical Centre was associated with early postoperative complications such as surgical site infection, wound dehiscence, skin flap necrosis, seroma/hematoma formation and abscess formation. We recommend that factors responsible for the incidence of these complications at Bugando Medical Centre should be addressed to reduce the occurrence of these complications.