Abstract
In this study, we describe the incidence, treatment, and outcome of breast cancer (BC) during the period 1994–2003 in the South-American country of Surinam and compare these with those of BC in the Netherlands. Pathology reports and hospital charts from all BC cases diagnosed between 1994 and 2004 were retrieved from Surinam’s single pathology laboratory and its five hospitals. Data on demographics, tumor characteristics, treatment, and follow-up were gathered. We compared our data to BC statistics of first generation immigrants from Surinam to the Netherlands. 421 patients were diagnosed with BC during the study period. The age-adjusted incidence rate was 26 per 100,000 compared to 65/100,000 in first generation Surinamese women in the Netherlands. The majority had a fairly advanced stage at presentation, with 60% of tumors larger than 2 cm, and 41.6% with lymph node involvement. Because of the absence of radiotherapy facilities, local treatment in most patients was radical mastectomy. Adjuvant hormonal therapy (51.6%) was administered more frequently than adjuvant chemotherapy (20.3%). A significant number of patients were lost to follow-up, resulting in a median follow-up duration of only 23 months. The 5-year overall survival was 79%. BC incidence in Surinam is low compared to that in the western world, but the advanced stage at diagnosis, the low utilization of systemic adjuvant therapy, and the inadequate follow-up may lead to poor outcomes. A number of steps are underway to improve the level of cancer care in Surinam.
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The authors are very grateful for the participation and assistance of all the persons and institutions in this study, as listed under Appendix.
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Appendix
Appendix
Surinam: Boards of hospitals and medical staffs.
Ministry of health: M. Eersel, MSc
Administrative staff of all participating hospitals
Paramaribo, Surinam:
Academisch Ziekenhuis
Surgery: R.B. Girjasing, MD. S. Nannan Panday, MD
Internal medicine: H.D. Chee, MD C.H. Adhin, MD, I.J. Lie Kiauw, MD J. Loor, MD, J.E. Anijs, MD
Diakonessenhuis
Surgery: A.E. Bergen MD
Internal medicine: S. Vreden, MD, E. Dams, MD, B.O. Hewitt, MD, M. van Eer, MD
‘s Lands Hospital
Surgery: J.H. de Bye, MD
Internal medicine: S Nannan Panday†, MD
St Vincentius Hospital
Surgery: M.N. Mohab Ali, MD
Internal medicine: A. Cameron, MD H. Dissels, MD
Nickerie, Surinam:
Streekziekenhuis Nickerie
Surgery: A.S. Li Fo Sjoe, MD
Pediatrics: N. Braafheid, MD
Vu medical center, Amsterdam, The Netherlands
W.R. Gerritsen MD, PhD
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van Leeuwaarde, R.S., Vrede, M.A., Henar, F. et al. A nationwide analysis of incidence and outcome of breast cancer in the country of Surinam, during 1994–2003. Breast Cancer Res Treat 128, 873–881 (2011). https://doi.org/10.1007/s10549-011-1404-7
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DOI: https://doi.org/10.1007/s10549-011-1404-7