[Management of breast cancers diagnosed at the Pasteur Institute of Madagascar from 1995 to 2001].

Breast cancer is a great problem of public health all over the world. In developed countries, breast cancer represents the most common cancer in females. Its incidence is also increasing in developing country. In Madagascar, no data is available to estimate the real incidence and prevalence rates of breast cancer. However, the data at the Institut Pasteur de Madagascar can confirm the extent of the problem even if it is not at a national scale. The authors report the results of a retrospective study from histological examination at the Laboratory of pathological anatomy of the IPM, during 7 years. Among 2,337 cases of cancer, 16% (373) were breast cancer. Most of them were a female breast cancer (356 cases). The average age is 48 years old. 30% of the tumors were more than 2 cm in size, corresponding at least to the T2 stade from the International Union Against Cancer anatomoclinical classification. The current histological type is the infiltrating ductal carcinoma (80%), about 2/3 belong to the grade 3 of the Scarff-Bloom-Richardson histopronostical classification. Early diagnosis of the cancer is difficult because of the insufficiency of the sanitary infrastructure, particularly for cervical and breast cancers. A national policy for screening must be set up in order to decrease the rate of these invasive carcinomas. In the meantime, informing women and training all the medical staff is a priority. Recording all the data in Madagascar would be desirable.