Evidence map›Paper›PMID 33008380›Full record

ArticleBMC health services research2020

Breast cancer pathology services in sub-Saharan Africa: a survey within population-based cancer registries.

Hannes-Viktor Ziegenhorn, Kirstin Grosse Frie, Ima-Obong Ekanem, Godwin Ebughe, Bakarou Kamate, Cheick Traore, Charles Dzamalala, Olufemi Ogunbiyi, Festus Igbinoba, Biying Liu and 5 more

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Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 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

29 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  8. Occupation and Female Breast Cancer Mortality in South Africa: A Case-Control Study.International journal of environmental research and public health · 2025
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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

15 authors.

Hannes-Viktor ZiegenhornInstitute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstrasse 8, 06097, Halle, Germany.
Kirstin Grosse FrieInstitute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstrasse 8, 06097, Halle, Germany.
Ima-Obong EkanemDepartment of Pathology, University of Calabar, Cancer Registry, Calabar, Nigeria.
Godwin EbugheDepartment of Pathology, University of Calabar, Cancer Registry, Calabar, Nigeria.
Bakarou KamateDepartment of Pathology, University of Bamako, Bamako Cancer Registry, Bamako, Mali.
Cheick TraoreDepartment of Pathology, University of Bamako, Bamako Cancer Registry, Bamako, Mali.
Charles DzamalalaUniversity of Malawi College of Medicine, Cancer Registry, Blantyre, Malawi.
Olufemi OgunbiyiUniversity of Ibadan, Cancer registry, Ibadan, Nigeria.
Festus IgbinobaNational Hospital Abuja, Abuja, Nigeria.
Biying LiuThe African Cancer Registry Network, INCTR African Registry Program, Oxford, UK.
Marcus BauerInstitute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Christoph ThomssenDepartment of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Donald Maxwell ParkinThe African Cancer Registry Network, INCTR African Registry Program, Oxford, UK.
Claudia WickenhauserInstitute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Eva Johanna KantelhardtInstitute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstrasse 8, 06097, Halle, Germany. Eva.kantelhardt@uk-halle.de.ORCID http://orcid.org/0000-0001-7935-719X

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundPathologists face major challenges in breast cancer diagnostics in sub-Saharan Africa (SSA). The major problems identified as impairing the quality of pathology reports are shortcomings of equipment, organization and insufficiently qualified personnel. In addition, in the context of breast cancer, immunohistochemistry (IHC) needs to be available for the evaluation of biomarkers. In the study presented, we aim to describe the current state of breast cancer pathology in order to highlight the unmet needs.

methodsWe obtained information on breast cancer pathology services within population-based cancer registries in SSA. A survey of 20 participating pathology centres was carried out. These centres represent large, rather well-equipped pathologies. The data obtained were related to the known population and breast cancer incidence of the registry areas.

resultsThe responding pathologists served populations of between 30,000 and 1.8 million and the centres surveyed dealt with 10-386 breast cancer cases per year. Time to fixation and formalin fixation time varied from overnight to more than 72 h. Only five centres processed core needle biopsies as a daily routine. Technical problems were common, with 14 centres reporting temporary power outages and 18 centres claiming to own faulty equipment with no access to technical support. Only half of the centres carried out IHC in their own laboratory. For three centres, IHC was only accessible outside of the country and one centre could not obtain any IHC results. A tumour board was established in 13 centres.

conclusionsWe conclude that breast cancer pathology services ensuring state-of-the-art therapy are only available in a small fraction of centres in SSA. To overcome these limitations, many of the centres require larger numbers of experienced pathologists and technical staff. Furthermore, equipment maintenance, standardization of processing guidelines and establishment of an IHC service are needed to comply with international standards of breast cancer pathology.

Indexed as

Africa South of the SaharaBreast NeoplasmsFemaleHumansImmunohistochemistryIncidencePathologistsRegistriesSurveys and QuestionnairesGuidelinesImmunohistochemistryPathologyPopulation-based cancer registrySub-Saharan Africa

Identifiers

PMID33008380
PMCPMC7531092

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Registered trials

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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.