Survival outcomes of breast cancer in Ghana: An analysis of clinicopathological features.

Abstract

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in female’s worldwide. Its incidence is on the ascendancy in Africa including Ghana. In addition, Ghanaian women are more likely to be diagnosed with high-grade tumours that are triple negative breast tumours. The objectives of the study were to investigate the clinicopathologic features of breast cancer in Ghanaian women; identify and describe breast cancer survival pattern in Ghana and factors that explain the disparity in survival rates for breast cancer by the use of Cox proportional hazard. Two thousand three hundred and ninety seven (2397) women were sampled for the study from the Korle-Bu Teaching Hospital (KBTH), of which 1022 (42.64%) were diagnosed with breast cancer between the periods 1st January 2002 to 31st December 2008. The cases were followed up to January 2011. It was found that Mean age for the cases was 47.97 years. The largest number of cases being 59.69% was aged 40 - 49 years. Invasive Ductal Carcinoma (IDC) was 72.90%, 71.28% had lump size of 2-5 cm. Axillary lymph node involvement was found in 90% of the women diagnosed with breast cancer. 5-year cumulative survival was 91.94% for stage 0&I and 15.09% for stage IV. Data relating to tumour grading were 92.07% for high grade 2 and 3. Triple negative breast cancer was identified in 66.38% (77 out of 116) of the cases with complete information on Estrogen Receptor, Progesterone Receptor and HER2 status. Cumulative 5-year survival was 47.91. Survival rate was better for early staged presentation; lymph node involvement of less than 25% and tumour size of less than 5 cm. The study reinforces the urgent need for improved screening techniques for early detection, and for an aggressive health education campaign to increase the awareness of women in Ghana about the potential risk of breast cancer and early detection by regular testing.