TITLE:
Survival Outcomes of Breast Cancer in Ghana: An Analysis of Clinicopathological Features
AUTHORS:
Alice C. Mensah, Joel Yarney, Sagary Kaku Nokoe, Samuel Opoku, J. N. Clegg-Lamptey
KEYWORDS:
Breast Cancer, Hormone Receptors, Survival Analysis, Tumour Size, Clinicopathological Features, Diagnosing Stage, Cox Proportional Hazard
JOURNAL NAME:
Open Access Library Journal,
Vol.3 No.1,
January
22,
2016
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.