Short-Term Surgical Mission in Sub-Saharan Country, Experience of a Breast-Dedicated Team: Reviewing the Past and Stepping Toward the Last Mission

Abstract

PURPOSEThe present article aims to present the data of a Breast Cancer Team Short-Term Surgical Mission in Guinea-Bissau in the setting of the National Bissau Hospital, Hospital Nacional Simão Mendes, level A referral health structure.PATIENTS AND METHODSPatients with breast disease have been presented to our team for in loco consultation during the total of three missions in 1 year. We have observed a total of 97 female patients with age ranging from 12 to 70 years. We performed 21 excisional biopsies, five radical surgeries, and 28 needle biopsies.RESULTSThere have been diagnosed 19 invasive breast cancer cases in stage IV, and in seven patients, the biopsy resulted in malignancy. On the recall consultation of the needle biopsied patients, just two returned and accepted the proposed treatment. Major issue has been the lack of trained pathology technicians for adequate sampling conditioning, a fact that led to a poor quality of 18 samples.CONCLUSIONAccess to surgical care is disparate across the world, and short-term surgical missions are often call-in action to deliver not only patient care but also local staff training. Complex disease management, such as cancer, may create several problems being conditioned by the lack of basic resources required. In Guinea-Bissau, a poor country with very few inhabitants, the need to implement an anticancer national strategy is urgent but seems feasible. Any action should prioritize local team training and enhance specialization. No external intervention can provide any long-term benefit for patients if they are detached from local health workers.