Dokolo Clinic IV Breast outreach- October 22nd 2025
Dokolo Clinic IV Breast outreach. October 22nd 2025
We planned this outreach at very short notice, and it is to the credit of the Dokolo team and the breast team that we managed to make it happen.
Mobilisation started with radio talks on the importance of breast checking and the important message that early detection of breast cancer can save so many patients.
Ocen Geoffrey kindly welcomed us to do this outreach for the people of Dokolo. Dr Odonggo signed our agreement and the Dokolo team provided 5 clinical rooms for the breast team to work in.
We were greeted with many ululations by the women waiting under the mango tree. Altogether, there were 245. The women had educational talks whilst waiting to be seen. Sr Jacintha sr Francisca, Sr Semmy, Sr Lillian Sr Kevin and Tile Ambrose were moving around fast doing the registrations, translations, sourcing extra chairs, and moving patients to the correct clinical spaces.
Our aim was to check all the women and a few men for their breasts. We did this by examining the breasts, our specialists for this were St Doryn from lira referral hospital, Sr Harriet from HCIV Ogur , Dr Jo Harvey from the Breast Service in the UK, and Dr Judy a breast consultant surgeon from the UK.
If patients had normal breasts we reassured them. If there were any lumps or thickenings, we did an ultrasound. We are lucky to have Ocwa Phyllis senior radiographer from Lira as a key member of the breast team to do this . We were also joined by Dr Isaac, a surgeon from Mulago who has ultrasound skills and was doing many ultrasounds and consultations in the minor ops room. In the main clinical area we also had Dr Emmanuel Odur from Apac hospital, who is skilled in ultrasound.
Patients who had a solid mass were able to have a needle biopsy under local anaesthetic in the minor ops room . Patients with an abscess could have the abscess drained and wounds dressed.
Lunch was a delicious meal of meat rice malakwang and posho.
We worked on well past sunset
In total we assessed 240 women and 5 men. Of these the vast majority described breast pain.. X
Breast lumps
nipple discharges. –
2 lumps that needed a biopsy and one of these might be a breast cancer,
but all the others were benign. In terms of age: 16 women were over 65: 52 aged between 41-65: 54 between 25 years and 40 years: 24 aged between 17 and 24 years, and 4 under 17.
Phyllis saw many non-breast patients as well. Some of these were antenatal patients, others had abdominal pain, inguinal hernia etc..
The clinic was busy busy busy. We saw almost double what we have seen in the average outreach days previously, and it is thanks to lira breast team and the new members plus the wonderful staff at Dokolo that we managed this number of patients.
This outreach clinic provided a wonderful educational opportunity.
Q: What happens to a woman with a cancer lump?
A: There is care for patients that have breast cancer.
The pathway is established now : If a woman finds a breast lump she needs to go to Tile Ambrose and he will send the patient to lira referral hospital on a Thursday . There the woman is seen in the surgical outpatient clinic. The doctors in the clinic will arrange an ultrasound of the breast and if necessary a biopsy. The lira Breast team co-ordinator Ongora Cosmas and Sr Philomena take the biopsy to the Gulu UCI ( Uganda cancer institute) in the van that the Lira Breast Team own and run. Once the biopsy result is available Gulu UCI inform Sr Philomena and Cosmas who then tell both the doctors in Lira and the patient. Sr Philomena counsels the woman. Then the woman has an appointment to be seen in the Gulu cancer institute.
The women will need in more ultrasound at CT scan. This is supported by the Lira breast team. If the woman needs chemotherapy, this is provided by the UCI. If she needs surgery this is free but there is a cost for consumables that the Lira breast team support. The woman may also need medicines. This is not yet negotiated. Radiotherapy is available in Kampala and the logistics mean that in effect it is not yet available for most of the Northen Ugandan patients.
The lira breast team van helps patients mobilise to Gulu for treatment.
We hope that the combination of community awareness to seek help with a breast lump, and a supported treatment pathway for a woman who has a breast cancer diagnosis means that over time we diagnose breast cancer earlier and therefore save them from unnecessary pain and suffering.
Thank you Dokolo HCIV.
Analysis of patients seen
249 patients waiting and registered . all given advice and education
Over 200 seen Most reassured and discharged .
At least 84 ultrasounds done
5 patients treated for infection.
10 patients with likely breast cancer
11 patients had an innocent lump
Detailed breakdown of patients
