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Characterizing breast conditions at an open-access breast clinic in South Africa: a model that is more than cancer care for a resource-limited setting.
- Source :
-
BMC health services research [BMC Health Serv Res] 2017 Jan 21; Vol. 17 (1), pp. 63. Date of Electronic Publication: 2017 Jan 21. - Publication Year :
- 2017
-
Abstract
- Background: While most breast-related research focuses on cancer, presentation of symptomatic persons in non-screened environments requires understanding the spectrum of breast diseases so as to plan services in resource-constrained settings. This study presents the variety of breast disease managed at a government, open-access breast clinic in South Africa.<br />Methods: We performed a retrospective file review using a systematic random sample of patients 18 years and above presenting for breast care over a 14-month period. We collected demographics, clinical characteristics, management and final diagnoses from the first visit and twelve subsequent months.<br />Results: The final sample contained 365 individuals (97 · 5% women). Most were black, unmarried and South African citizens with a median age of 43 years (IQR 31-55) . Of those reporting their status (24 · 1%) 38 · 6% were HIV-positive. A mass (57 · 0%) and/or pain (28 · 5%) were the most common symptoms. Imaging and breast biopsies were required in 78 and 25% of individuals, respectively. Nearly half of biopsies identified breast cancer (44 · 1% of women ≤40 and 57 · 3% for women >40). Benign conditions (47 · 7%) and no abnormality (18 · 2%) were common final classifications among women. There was no difference between the final classifications of patients who self-referred versus those who were formally referred from another health care provider. Nearly half of the participants (46 · 6%) travelled 20 km or more to attend the clinic.<br />Conclusions: Benign breast conditions far outweighed cancer diagnoses. As breast cancer awareness increases in resource-limited countries, facilities offering breast care require administrative and clinical preparation to manage a range of non-cancer related conditions.
- Subjects :
- Adult
Ambulatory Care Facilities economics
Ambulatory Care Facilities statistics & numerical data
Antineoplastic Agents economics
Breast Neoplasms economics
Female
HIV Seropositivity epidemiology
Humans
Male
Middle Aged
Oncology Service, Hospital standards
Quality Assurance, Health Care
Retrospective Studies
South Africa epidemiology
Tertiary Care Centers
Ambulatory Care Facilities organization & administration
Antineoplastic Agents therapeutic use
Black People
Breast Neoplasms diagnosis
Health Resources
Oncology Service, Hospital organization & administration
Subjects
Details
- Language :
- English
- ISSN :
- 1472-6963
- Volume :
- 17
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC health services research
- Publication Type :
- Academic Journal
- Accession number :
- 28109290
- Full Text :
- https://doi.org/10.1186/s12913-016-1959-4