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Breast cancer is now the commonest cancer in most sub-Saharan African countries. Few studies of the epidemiology and genomics of breast cancer and its molecular subtypes in these countries have been done. The African Female Breast Cancer Epidemiology (AFBRECANE) study, a part of the Human Heredity and Health in Africa (H3Africa) initiative, is designed to study the genomics and epidemiology of breast cancer and its molecular subtypes in Nigerian women. We link recruitment of breast cancer cases at study sites with population-based cancer registries activities to enable ascertainment of the incidence of breast cancer and its molecular subtypes. We use centralized laboratory processing to characterize the histopathological and molecular diagnosis of breast cancer and its subtypes using multiple technologies. By combining genome-wide association study (GWAS) data from this study with that generated from 12,000 women participating in our prospective cohort study of cervical cancer, we conduct GWAS of breast cancer in an entirely indigenous African population. We test associations between dietary intakes and breast cancer and focus on vitamin D which we measure using dietary intakes, serum vitamin D, and Mendelian randomization. This paper describes the AFBRECANE project, its design, objectives and anticipated contributions to knowledge and understanding of breast cancer.

Familial adenomatous polyposis is rare. Three cases were previously reported in Nigeria. An intriguing feature of this case is an ulcerated jejunal carcinoma which was metastatic rather than synchronous carcinoma. This patient presented with partial large bowel obstruction and the pathological analysis revealed 4 invasive adenocarcinomas, 3 in the colon and 1 in the jejunum (Dukes stage D). Palliative pancolectomy and jejunal tumour resection with chemotherapy was offered to him. He died eight months after surgery from disease progression. The challenges of managing a hereditary cancer syndrome in a resource poor country are highlighted.

Objective: To define the incidence of, and factors contributing to the complications of colostomy and colostomy closure at the University College Hospital, Ibadan, Nigeria. Patients and Method: Retrospective review of hospital records of all the patients that had colostomy/colostomy closure in the hospital from 1985 to 1994 was conducted. Two hundred and sixty nine colostomies were performed, 154 of which were fully evaluated. Loop colostomies on the sigmoid (35.7%) and transverse colon (27.3%) were most commonly performed. Indications for colostomy in adults were rectal carcinoma, acquired fistulae, colorectal injury and colonic obstruction. Anorectal anomalies and Hirschsprung's disease were the indications in children. Complications and deaths related to colostomy and colostomy closures were noted. Results: Death rate was 17.6% mostly from sepsis. Mortalities were higher (p

Background: Pleurodesis is an effective treatment for malignant pleural effusion but the ideal agent that will combine efficacy with safety and ease of administration remains under debate. Injectable tetracycline used to be the preferred agent for sclerosis for many clinicians but it has been withdrawn from the market. There is thus an ongoing search for suitable and better alternatives. In a third world environment, cost is a major determinant of use of some agents. Some patients have already been heavily pretrcated with systemic cytotoxic drugs while some are too weak for agents with cytotoxic activity. All these limit the choice of agents available to us. Patients and Methods: Capsules of tetracycline were dissolved in sterile water and this was injected through a thoracostomy tube in patients with malignant pleural effusion from breast cancer. The efficacy was measured by its ability to the control effusion for at least 30 days as evidenced by non recurrence of clinical xsfeatures of effusion necessitating re-treatment and/or chest radiology showing more than 50% fluid re-accumulation. Results: Twelve pleural effusions were treated with capsule tetracycline pleurodesis. Eleven effusions satisfied evaluation criteria. Eight of eleven evaluable pleural effusions (72.7%) were controlled for at least 30 days or until patient′s death or loss to follow up. The reactions following the use of the agent were minimal comprising only of mild to moderate chest pain, an episode of fever, body aches and vomiting. All the symptoms were controlled by simple measure like analgesics. Conclusion: Capsule tetracycline has shown good promise as a sclerosing agent for pleurodesis. A prospective randomized trial comparing it with other known agents is warranted.