Breast cancer treatment and outcomes at Cape Coast Teaching Hospital, Ghana

  • Fejiro O. Okifo Harvard Medical School, Boston, MA
  • Derek A. Tuoyire Department of Community Medicine, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
  • Anthony B. Appiah Ghana Field Epidemiology and Laboratory Training Program (GFELTP), School of Public Health, University of Ghana-Legon, Accra, Ghana
  • Samuel Y. Debrah Department of Surgery, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
  • Martin T. Morna Department of Surgery, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
  • Rosemary B. Duda Department of Surgery, Division of Surgical Oncology, Beth Israel Deaconess Hospital, Harvard Medical School, Boston, MA
Keywords: Breast cancer, advanced stage presentation, treatment, Cape Coast, Ghana, Sub-Saharan Africa

Abstract

Objectives: This study sought to determine the presentation, treatment and outcomes of breast cancer among women in Cape Coast, Ghana.
Design: Retrospective medical record review
Setting: Cape Coast Teaching Hospital, Cape Coast, Ghana
Participants: Female breast cancer patients
Interventions: None
Main outcome measures: Proportion of female breast cancer patients presenting with advanced disease.
Results: 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%).
Conclusions: Women with breast cancer typically present to the Cape Coast Teaching Hospital with advanced stage disease and experience poor outcomes.

Published
2021-09-30

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print ISSN: 0016-9560