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Breast cancer diagnosis in a resource poor environment through a collaborative multidisciplinary approach: the Kenyan experience
  1. Shahin Sayed1,
  2. Zahir Moloo1,
  3. Peter Bird2,
  4. Ronald Wasike1,
  5. Wambui Njoroge3,
  6. Joseph Karanu4,
  7. Ancent Nzioka2,
  8. Omar Sherman5,
  9. Satya Prasad6,
  10. Costa Mariwa6,
  11. James Obondi Otieno7,
  12. David Chumba8,
  13. David Koech8,
  14. Daniel Mbinga5,
  15. Musa Mohammed9,
  16. Richard Njoroge9,
  17. Rajendra Chauhan1,
  18. Sudhir Vinayak1,
  19. Catherine Kyobutungi10,
  20. Mansoor Saleh11
  1. 1Department of Pathology, Surgery and Radiology, Aga Khan University Hospital Nairobi, Nairobi, Kenya
  2. 2Department of Surgery and Pathology, African Inland Church Kijabe Hospital, KIjabe, Kenya
  3. 3Department of Surgery, Provincial General Hospital Nyeri, Nyeri, Kenya
  4. 4Department of Surgery, St. Mary’s Mission Hospital Nairobi, Nairobi, Nairobi, Kenya
  5. 5Department of Pathology and Surgery, Aga Khan Hospital Mombasa, Mombasa, Kenya
  6. 6Department of Pathology and Surgery, Aga Khan Hospital Kisumu, Kisumu, Kenya
  7. 7Department of Surgery, New Nyanza General Hospital, Kisumu, Kenya
  8. 8Department of Pathology and Surgery, Moi Teaching and Referral Hospital, Eldoret, Kenya
  9. 9Department of Surgery and Pathology, Provincial General Hospital Garissa, Garissa, Kenya
  10. 10African Population and Health Research Centre, Nairobi, Kenya
  11. 11Department of Medicine, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama, USA
  1. Correspondence to Dr Shahin Sayed, Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270, 3rd Parklands Avenue, Nairobi 00100, Kenya; shaheen.sayed{at}


INTRODUCTION The majority of women with breast cancer in Kenya present with node-positive (stage II) or locally advanced Q7 disease (stage IIIB). Diagnosis is made on fine needle aspirate cytology and treatment is with surgery if resectable. Diagnostic core biopsy is available only at subspecialty hospitals. Processing and reporting of biopsy tissue are not standardised. Hormone receptor and HER2 analyses are rarely done preoperatively.

METHODS As part of a larger study investigating the prevalence of triple negative breast cancer in Kenya, a multidisciplinary workshop of collaborators from 10 healthcare facilities was held. Process gaps were identified, preanalytic variables impacting on ER/PR/HER2 discussed and training in core biopsy provided. Local remedial strategies were deliberated.

CONCLUSION We describe our experience and outcome from the workshop, which can be modelled for other resource poor settings.

  • Breast Cancer
  • Fixation
  • Immunohistochemistry
  • Breast Pathology
  • Hormone

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