Trends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, Yemen

Background: Breast cancer is the most common cancer of women and the principal cause of death in middleaged women. The objective of this study was to describe the trend of breast cancer and its management in Adenand adjacent south-eastern governorates of Yemen during the last 20 years. Patients and
Methods: This is aretrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-easterngovernorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time andtype of presentation, disease stage, pathological types and the performed surgical treatment. The sources ofinformation were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; majorreferral and other public and private hospitals in Aden and Aden Cancer Registry.
Results: The total numberof patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years(60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signsof advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer(stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was thecommonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy(50%).
Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanceddisease. Improving health awareness and earlier diagnosis of the disease by health education, encouragingbreast self-examination, and providing the mammography equipment and mammary clinics in hospitals arerecommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.