1. POSTMASTECTOMY LIFE QUALITY IN PATIENTS WITH BREAST CANCER IN Khartoum BY MOHAMED TOUM MUSA M IBRAHIM, PROFESSOR OF SURGERY UNIVERSITY OF KHARTOUM IASGO 2015- FUZHOU- SUN 06 TH SEP

2. Authors  Mohamed Toum M Ibrahim- Professor of Surgery  Randa Zaki A Khair- Associate Professor of Surgery University of Khartoum IASGO 2015- FUZHOU

3. INTRODUCTION  HISTORICAL BACKGROUND: A.R ADICAL M ASTECTOMY : o Dr William S Halsted did his first radical mastectomy in 1882 o It remained the standard treatment for breast cancer for a century o Halsted was the: o First to put gloves on hands of surgical team o Pioneer in regional anaesthesia (for own-self  cocaine addiction) B.In 1972 shift to M ODIFIED R ADICAL M ASTECTOMY had occurred (P ATEY ’ S ) IASGO 2015- FUZHOU

4. LOCAL BACKGROUND 1995 SMJ Professors Lynch, A M ElHassan & A Omar  Cancer in Sudan (Jan 1954- Dec 1961): Breast cancer specimens 261 Males 11 RICK: Cancer Registry 2000- 2007: total number of cancer patients was 27000 Breast cancer contributes 17.5% (4892): in the top of the list Breast cancer forms 34% of all female cancers IASGO 2015- FUZHOU INTRODUCTION…

5. T YPES OF MASTECTOMY :  Simple  Modified radical  Radical  Skin sparing  Subcutaneous  Quadrentectomy  Lumpectomy I NDICATION FOR TRADITIONAL MASTECTOMY :  Radiation therapy to affected breast  > 2 lesions in the same breast  If lumpectomy did not remove the cancer  Women with connective tissue disease  Pregnant women  Tumour size > 5 cm  Male breast cancer IASGO 2015- FUZHOU INTRODUCTION…

6. OBJECTIVES To evaluate the quality of life & achievements in patients with breast cancer after mastectomy To throw light on the prognosis of breast cancer in Sudanese patients IASGO 2015- FUZHOU

7. PATIENTS & METHODS Prospective study in Medical & Health Services Centre of the University of Khartoum 162 women with breast cancer Study period 1996- 2011 Patients Characteristics, General Health & Illness Perception Questionnaires were used for data collection Patients were followed up after mastectomy for 1- 14 (mean 4+ 2) years Male patients were excluded Data were analyzed using SPSS IASGO 2015- FUZHOU

8. RESULTS & DISCUSSION Mean age 50+ 9 (range 21- 80) years Rt & Lt side were involved almost equally Family history was positive in 31% Mastectomy was done for all patients No operative mortality was reported 5-year survival rate was 90% IASGO 2015- FUZHOU

9. RESULTS…  Physical, functional, emotional & sexual wellbeing were questioned  Overall satisfaction was 75%  77% of women were unsatisfied with body image initially (but improved by time)  Depression & anxiety were found in 25%within the first 3 months (decreased to 15% after 3 years)  Sexual pleasure was not affected by mastectomy significantly IASGO 2015- FUZHOU GENERAL HEALTH AFTER MASTECTOMY (N= 64)

10. RESULTS… ACHIEVEMENTS AFTER MASTECTOMY (N= 35) IASGO 2015- FUZHOU FUNCTIONAL WELLBEING- SPIRITUAL & COGNITIVE ACHEIVEMENTS  23%  able to go to Pilgrimage or Omra  3%  children  2%  high academic qualification & career promotion  No single divorce

11. CONCLUSIONS 1.Life quality in Sudanese patients with breast cancer is above average 2.Achievements in patients with breast cancer are great after mastectomy 3.The overall 5-year survival rate in this study is 90% in patients with stage I, II IASGO 2015- FUZHOU

12. RECOMMENDATIONS  Management of breast cancer should be by a team: surgeon, pathologist, radiologist, psychologist & oncologist  Counselling of patients is essential  Psychological preparation of patients is essential IASGO 2015- FUZHOU