3.AO_866_GUI_Imagerie dans le bilan métastatique initial des cancers du sein

CONDÉ Ibrahima Kalil; CAMARA Bountouraby; CISSÉ Kalil; BAH Malick; KEITA Mamady; TOURÉ Alhassane Ismael; CAMARA Abou; TRAORÉ Bangaly

doi:10.55715/jaim.v18i4.1025

Authors

CONDÉ Ibrahima Kalil
CAMARA Bountouraby
CISSÉ Kalil
BAH Malick
KEITA Mamady
TOURÉ Alhassane Ismael
CAMARA Abou
TRAORÉ Bangaly

DOI:

https://doi.org/10.55715/jaim.v18i4.1025

Abstract

Objectives. This study aimed to assess the contribution of imaging in the detection of initial metastases in breast cancer in Guinea.

Materials and Methods. This was a retrospective, descriptive, and analytical study conducted over 5 years (2020–2024) in the Oncology Department of Donka University Hospital (CHU Donka). The study included all patient records with histologically confirmed breast cancer who underwent an initial staging workup using imaging that explored at least two anatomical regions (thoracic and abdominopelvic) and whose cases were discussed during a multidisciplinary oncology tumor board meeting (MDT). Records of patients with incomplete staging workups, no initial imaging, not presented at the MDT, or deemed unusable were excluded. The imaging examinations considered included, among others: thoraco-abdomino-pelvic computed tomography (TAP CT) with or without brain CT when indicated, chest radiography, abdominopelvic ultrasound, magnetic resonance imaging (MRI), and bone scintigraphy. Interpretation was based on radiology reports, which were reviewed and validated during MDT meetings.

Results. During the study period, 636 confirmed cases of breast cancer were recorded, of which 280 patient records were included. The mean age was 44.0 ± 13.0 years, and 98.5% of patients were female. At admission, 78.2% presented with locally advanced disease. TAP CT with or without brain imaging (56.07%) and the combination of chest radiography and abdominopelvic ultrasound (44.3%) were the most commonly used imaging modalities. Imaging detected metastases in 33.2% of cases, compared with 8.6% detected clinically. The most frequent metastatic sites were the lungs (73.1%), liver (22.6%), and bones (20.4%). A discrepancy between clinical staging (cTNM) and radiological staging (iTNM) was observed in 30.4% of cases (p < 0.001).

Conclusion. Imaging significantly improves the detection of initial metastatic disease in breast cancer in Guinea. Expanding access to advanced imaging techniques is essential for accurate staging and more appropriate management.

RESUME

Objectifs. Cette étude visait à évaluer l’apport de l’imagerie dans la détection des métastases initiales du cancer du sein en Guinée.

Matériels et méthodes. Il s’agissait d’une étude rétrospective, descriptive et analytique sur 5 ans (2020–2024) réalisée au service de cancérologie du CHU Donka, incluant tous les dossiers de patients avec un cancer du sein confirmé ayant bénéficié d’un bilan d’extension initial par imagerie explorant au moins deux étages anatomiques (thoracique et abdomino-pelvien), et discutés en réunion de concertation pluridisciplinaire (RCP) de cancérologie. N’ont pas été inclus les dossiers de patients ayant un bilan d’extension incomplet, n’ayant pas d’imagerie initiale, non présentés en RCP ou étaient inexploitables. Les examens réalisés pris en compte étaient entre autres : la tomodensitométrie thoraco-abdomino-pelvienne (TDM TAP) et cérébrale si nécessaire, la radiographie thoracique, l’échographie abdomino-pelvienne, l’imagerie par résonance magnétique (IRM) et la scintigraphie osseuse. L’interprétation reposait sur les comptes rendus radiologiques, analysés et validés en RCP.

Résultats. Durant la période d’étude, 636 cas de cancer du sein confirmé ont été enregistrés, dont 280 dossiers ont été colligés. L’âge moyen était de 44,0 ± 13,0 ans ; 98,5 % étaient de sexe féminin. À l’admission, 78,2 % présentaient une forme localement avancée. La TDM TAP ± cérébrale (56,07 %) et l’association radiographie/échographie abdominopelvienne (44,3 %) étaient les examens les plus utilisés. L’imagerie avait révélé des métastases chez 33,2 % des cas, contre 8,6 % détectées cliniquement. Les localisations secondaires les plus fréquentes étaient pulmonaires (73,1 %), hépatiques (22,6 %) et osseuses (20,4 %). Une discordance entre les stades clinique (cTNM) et radiologique (iTNM) a été observée dans 30,4 % des cas (p < 0,001).

Conclusion. L’imagerie améliore significativement la détection des métastases initiales du cancer du sein en Guinée. Son accessibilité doit être renforcée pour une stadification fiable et une prise en charge plus adaptée.

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