Evidence map›Paper›PMID 29866062›Full record

ArticleBMC cancer2018

Pregnancy-associated breast cancer in rural Rwanda: the experience of the Butaro Cancer Center of Excellence.

Jean Marie Vianney Dusengimana, Vedaste Hategekimana, Ryan Borg, Bethany Hedt-Gauthier, Neil Gupta, Susan Troyan, Lawrence N Shulman, Ignace Nzayisenga, Temidayo Fadelu, Tharcisse Mpunga and 1 more

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In one paragraph

Article in BMC cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jean Marie Vianney DusengimanaPartners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda. jmvduse@gmail.com.ORCID http://orcid.org/0000-0002-3074-1091
Vedaste HategekimanaMinistry of Health, Butaro District Hospital, Butaro, Rwanda.
Ryan BorgPartners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda.
Bethany Hedt-GauthierPartners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda.
Neil GuptaPartners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda.
Susan TroyanHarvard Medical School, Boston, MA, USA.
Lawrence N ShulmanUniversity of Pennsylvania, Philadelphia, PA, USA.
Ignace NzayisengaPartners In Health/Inshuti Mu Buzima, P.O.Box 3432, Kigali, Rwanda.
Temidayo FadeluDana Farber Cancer Institute, Boston, MA, USA.
Tharcisse MpungaMinistry of Health, Butaro District Hospital, Butaro, Rwanda.
Lydia E PaceHarvard Medical School, Boston, MA, USA.

Funding

Breast Cancer Research Foundation BCRF-17-147Partners In Health/Inshuti Mu Buzima - Intermediate Operational Research Training Program Not applicable
6 · The paper itself

Abstract

backgroundBreast cancer is the most common malignancy encountered during pregnancy. However, the burden of pregnancy-associated breast cancer (PABC) and subsequent care is understudied in sub-Saharan Africa (SSA). Here, we describe the characteristics, diagnostic delays and treatment of women with PABC seeking care at a rural cancer referral facility in Rwanda.

methodsData from female patients aged 18-50 years with pathologically confirmed breast cancer who presented for treatment between July 1, 2012 and February 28, 2014 were retrospectively reviewed. PABC was defined as breast cancer diagnosed in a woman who was pregnant or breastfeeding. Numbers and frequencies are reported for demographic and diagnostic delay variables and Wilcoxon rank sum and Fisher's exact tests are used to compare characteristics of women with PABC to women with non-PABC at the alpha = 0.05 significance level. Treatment and outcomes are described for women with PABC only.

resultsOf the 117 women with breast cancer, 12 (10.3%) had PABC based on medical record review. The only significant demographic differences were that women with PABC were younger (p = 0.006) and more likely to be married (p = 0.035) compared to women with non-PABC. There were no significant differences in diagnostic delays or stage at diagnosis between women with PABC and women with non-PABC women. Eleven of the women with PABC received treatment, three had documented treatment delays or modifications due to their pregnancy or breastfeeding, and four stopped breastfeeding to initiate treatment. At the end of the study period, six patients were alive, three were deceased and three patients were lost to follow-up.

conclusionsPABC was relatively common in our cohort but may have been underreported. Although patients with PABC did not experience greater diagnostic delays, most had treatment modifications, emphasizing the potential value of PABC-specific treatment protocols in SSA. Larger prospective studies of PABC are needed to better understand particular challenges faced by these patients and inform policies and practices to optimize care for women with PABC in Rwanda and similar settings.

Indexed as

AdolescentAdultBreast NeoplasmsDelayed DiagnosisFemaleHumansMiddle AgedPregnancyPregnancy Complications, NeoplasticRwandaYoung AdultAfricaBreast cancerBreastfeedingPregnancy

Identifiers

PMID29866062
PMCPMC5987575

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.