Itinéraires thérapeutiques des femmes atteintes de cancer du sein dans trois hôpitaux universitaires de Yaoundé

Abstract

Context: Breast cancer is the most common cancer of women in Africa like in the world. The incidence grow more and more as well as his mortality. In Cameroon, women who are on treatment in biomedicine are in advanced stages of cancer-- stage III and IV. Several factors could justify this late resort to hospital treatment. Among which a course of care undertaken by these women that would be multiple ranging from self-medication, through ethno medicine to biomedicine. Objectives: The main purpose of this study is to determine the therapeutic routes of women with breast cancer in three university hospitals. Methodology: To do this, this study was a descriptive and cross-sectional study at HGY, HGOPY and HCY targeting women with breast cancer. Thus, two collection tools were used namely a questionnaire for the quantitative evaluation and an interview guide for the qualitative evaluation. After receiving the recruitment authorizations in the various hospitals, the information were collected after informed consent and self-administration of the collection tools. Then we analyzed the quantitative data using the IBM-SPSS software and the qualitative data were transcribed in the textual corpus. The interest of this work was to determine the place of the different care pathways used by women with breast cancer in the late use of biomedicine. Results: The average age was 42 +/- 12.09 years, the youngest was 25 years old and the oldest was 79 years old. The most common group was women over 45 at 57.2%. Monthly earnings were acceptable at 53.7% More than one-third of women resided more than 15 kilometers from the two major referral hospitals. Regarding clinical-pathological parameters, 15.2% had familial history of breast cancer. Of the parity, 91.3% of women had already given birth to a child. Nearly half of the women seen were in stage III (46.9%) The most common histological type was carcinoma in 94.5% and all tumors were infiltrating. The vast majority of cancer was found by a nodule in the breast at 64%. The majority 93.2% had no knowledge about breast self-examination. Breast pain was the second mode of revelation, 9.7%. The most frequent recourse was biomedicine at 64% as a first recourse but a third had abandoned to turn to traditherapy and self-medication in the traditional pharmacopoeia. The second most represented recourse was therapeutic abstention 26% because it considered that the disease was benign in 72% of cases, was afraid of the diagnosis in 11.4% and lack of funding in 11.4%. It is the aggravation that led them to the hospital. Traditherapy was also a recourse undertaken by 5% at the first resort and 18.7% at the second resort. These latter gave up by therapeutic inefficiency for 10.3% of women and by counsel in 6.9%. Other remedies were also undertaken among which spiritual treatments, self-medication in traditional pharmacopoeia and fetishism were respectively 3%, 4% and 13% pursued for supposed therapeutic efficacy. In addition, in 36% of cases, medical treatment was associated with other treatments, namely self-medication in traditional pharmacopoeia in 50% of cases and ethno medicine in 15% of cases.

Conclusion: The itineraries of women with breast cancer are multiple and interwoven. Thus, they justify the delay in the management of biomedicine and the fact that they are encountered at an advanced stage of cancer.