Breast Cancer Treatment and Outcomes at Cape Coast Teaching Hospital, Ghana

Abstract

Objective: Breast cancer is a recognized major health condition in Ghana, with the incidence rising due to an aging population, socioeconomic development, and an increasingly Westernized lifestyle. Breast cancer treatment and outcomes were analyzed at Cape Coast Teaching Hospital, Ghana. Methods: A retrospective medical record review of 197 female patients diagnosed with invasive breast cancer was performed. Data collection included operative procedure, postoperative complications, chemotherapy and radiation treatment, pathology and survival. Statistical analysis was performed using SPSS Statistics and included descriptive statistics, Pearson correlation, binary logistic and multinomial regression analysis. Results: An operative procedure for cure or local control was performed in 106 women and included partial mastectomy (21.7%) and total mastectomy (78.3%). The most common post-operative complication was a surgical site infection (3.8%). Grade 1 cancers were diagnosed in 11.0%, Grade 2 in 43.8%, and Grade 3 in 45.2%. Mean cancer size was 6.5 centimeters (range 1.5 to 20.0 cm). Lymphatic vascular invasion (LVI) was present in 59/125 (47.2%), estrogen receptor status was positive in 31/117 (32.6%), progesterone receptors were positive in 21/117 (22.1%), and Her-2/neu was positive in 29/123 (32.6%). Triple negative breast cancer (TNBC) was identified in 41/89 (46.1%). Stage 3 and Stage 4 cancer patients were twofold more likely to receive neoadjuvant chemotherapy compared with earlier stages (OR= 2.0 95% CI (1.4, 3.0, p<0.001). Conclusions: Ghanaian women frequently present with advanced stage breast cancer and experience poor outcomes. Public health initiatives should focus on dispelling harmful beliefs that delay women from seeking care. Expansion of the national health care system is needed to support breast cancer screening, diagnostic tests, and treatment.