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Breast cancer treatment and outcomes at Cape Coast Teaching Hospital,Ghana
Authors:Fejiro O Okifo  Derek A Tuoyire  Anthony B Appiah  Samuel Y Debrah  Martin T Morna  Rosemary B Duda
Abstract:ObjectivesThis study sought to determine the presentation, treatment and outcomes of breast cancer among women in Cape Coast, Ghana.DesignRetrospective medical record reviewSettingCape Coast Teaching Hospital, Cape Coast, GhanaParticipantsFemale breast cancer patientsInterventionsNoneMain outcome measuresProportion of female breast cancer patients presenting with advanced disease.ResultsApproximately 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%).ConclusionsWomen with breast cancer typically present to the Cape Coast Teaching Hospital with advanced stage disease and experience poor outcomes.FundingFunding for this study was provided by the Harvard Medical School Scholars in Medicine.
Keywords:Breast cancer  advanced stage presentation  treatment  Cape Coast  Ghana  Sub-Saharan Africa
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