Abstract

CLINICAL AND LABORATORY OUTCOME EVALUATION OF BREAST CANCER PATIENTS IN MAIDUGURI-CITY, NIGERIA: A GUIDE FOR MONITORING CHEMOTHERAPY AND OTHER MANAGEMENT MODALITIES

John David Ohieku* and Oluchukwu Theresa Anagboso

ABSTRACT

Background: Intermediate clinical outcome evaluation and laboratory monitoring of breast cancer patients are desirable in order to identify critical areas needing further attention. Aim and Objectives: The objectives of the study are to identify the risk factors associated with breast cancer in the region and to evaluate the adverse effects of medication experienced by patients. The study also aimed at assessing changes in the laboratory parameters of patients during care and the clinical implication of such changes. Materials and method: A total of 146 breast cancer patients were assessed between year 2010 and 2015 through retrospective study. Demographic information were retrieved and clinical treatment outcome such as adverse drug effects as well as laboratory parameters like electrolyte levels, albumin, total protein, uric acid, creatinine, urea levels, white blood cell and packed cell volume were assessed with chemotherapy progression. Results: The mean age and standard deviation of patients was 46.98 ± 11.71 years. Peaked age for breast cancer occurred in those in their fourth decades of life but the greatest age of risk was 30-69 years. Male subjects with breast cancer were 4.1% compared to 95.9% female. Family history of breast cancer was positive in 6.8% patients and the left sided breast was the most affected site (being 60.3%). The laboratory values were below the normal range for sodium 32(24.4%), potassium 31 (23.7%), chloride 25(19.4%), and bicarbonates 112 (86.9%).The creatinine, urea and uric acid were elevated in 22 (19.3%), 12 (9.3%) and 22 (59.5%) patients respectively. Low albumin and low total protein level occurred in 24(25.3%) and 12 (14.0%) respectively. The adverse drug effects were decreased blood count 75 (51.4%), polyuria 5(3.4%), vomiting 33(22.6%) and constipation 54(37.0). Conclusion: Being a woman, older age, obesity, family history were the major risk factors observed. Some adverse drug effects may have influenced some of the changes in laboratory results observed. There were several potential problems associated with chemotherapy or their adverse effects or other management procedures observed and several laboratory results may have some pharmacokinetic or pharmacotherapeutic implications. These findings underscore the need to always monitor the chemotherapy and other treatment procedures adopted for breast cancer patients.

Keywords: Breast cancer, Male breast cancer, Tamoxifen, Hyponitraemia, hyperkalaemia, Nausea and Vomiting, Cyclophosphamide.