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Morbidity, mortality and survival in the management of cT4 breast cancer in Nigeria.

The absence of other modalities mandates surgical management of T4 breast cancer in Nigeria. The management, course and survival of 120 Nigerian females who presented with breast cancer in stage UICC T4N1-2MO were studied prospectively. All patients underwent total mastectomy and partial axillary dissection. Eighty patients (group 2) who received postoperative chemotherapy were matched to 40 patients (group 1) who did not receive chemotherapy. Group 1 patients had significantly earlier tumor recurrence, more rapid progression to M1 disease, required hospitalization more often and for longer periods, had earlier deterioration of Karnofsky index and a shorter survival than group 2 patients. Although the overall survival even for group 2 patients was low, the achievement of local tumor control, the avoidance of uncontrolled tumor growth, delay in recurrent disease and the achievement of a measure of social acceptability and prolongation of life justifies surgical management plus chemotherapy in circumstances like ours, where no better modality is available, for the management of cT4 breast cancer.