Breast cancer treatment and outcomes at Cape Coast Teaching Hospital, Ghana
Fejiro O. Okifo, Derek Anamaale Tuoyire, Anthony Baffour Appiah, Samue Y. Debrah, Martin Tangnaa Morna, Rosemary B. Duda
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. Funding: Funding for this study was provided by the Harvard Medical School Scholars in Medicine.