Abstract
This study sought to determine the presentation, treatment and outcomes of breast cancer among women in Cape Coast, Ghana. Retrospective medical record review. Cape Coast Teaching Hospital, Cape Coast, Ghana. Female breast cancer patients. None. Proportion of female breast cancer patients presenting with advanced disease. Approximately 84% of women had a primary presentation of breast cancer, with metastatic disease present in 34% of patients. Surgical management mainly involved partial mastectomy (21.7%) and total mastectomy (78.6%), with the most common postoperative complications being surgical site infections (3.8%). Non-surgical management involved chemotherapy, radiation therapy and anti-estrogen therapy, with Stage 3 and 4 patients twofold more likely to receive neoadjuvant chemotherapy than earlier stages (OR= 2.0 95% CI (1.4, 3.0, p<0.001). Grade 1 cancers were diagnosed in 11.0%, Grade 2 in 43.8%, and Grade 3 in 45.2%. The mean cancer size was 6.5 centimetres (range 1.5 to 20.0). Lymphatic vascular invasion was present in 59/125 (47.2%), estrogen receptor status was positive in 32.6%, progesterone receptors were positive in 22.1%, and Her-2/neu was positive in 32.6%. Triple-negative breast cancer was identified in 41/89 (46.1%). Women with breast cancer typically present to the Cape Coast Teaching Hospital with advanced stage disease and experience poor outcomes. Funding for this study was provided by the Harvard Medical School Scholars in Medicine.
Highlights
The increasing burden of cancers in many low-and middle-income countries has become a great public health concern
Adeloye et al estimated the incidence of breast cancer in Africa as 24.5 per 100,000 person years, which represents an increase from 20.1 per 100,000 person years in 2000 to 28.9 per 100,000 person years in 2015.2 In Ghana, data obtained via Globocan indicates that new patients of breast cancer in 2018 represented 20.4% of all cancers in both sexes and 33.6% in females.[1]
Study setting and design We conducted a retrospective review of medical records of breast cancer patients diagnosed from 2011 to 2019 at the Cape Coast Teaching Hospital (CCTH), Ghana
Summary
The increasing burden of cancers in many low-and middle-income countries has become a great public health concern. Breast cancer is recognized as an increasingly important burden of disease, among women in African countries. Western Africa had 45,157 new patients with breast cancer in 2018 and 20,983 deaths relating to breast cancer.[1] Adeloye et al estimated the incidence of breast cancer in Africa as 24.5 per 100,000 person years, which represents an increase from 20.1 per 100,000 person years in 2000 to 28.9 per 100,000 person years in 2015.2. Despite the observed increases in the incidence of breast cancer in low-and middle-income countries, the rates are still generally low compared to high-income countries
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