Background Breast cancer is the commonest cancer diagnosed globally and the second leading cause of cancer-related mortality among women younger than 40 years. This study comparatively reviewed the demographic, pathologic and molecular features of Early-Onset Breast Cancer (EOBC) reported in Ghana in relation to Late Onset Breast Cancer (LOBC). Methods A descriptive, cross-sectional design was used, with purposive sampling of retrospective histopathology data from 2019 to 2021. Reports of core or incision biopsy, Wide Local Excision or Mastectomy with or without axillary lymph node dissection specimen and matched immunohistochemistry reports were merged into a single file and analysed with SPSS v. 20.0. Descriptive statistics of frequencies and percentages were used to describe categorical variables. Cross-tabulation and chi-square test was done at a 95% confidence interval with significance established at p < 0.05. Results A total of 2418 cases were included in the study with 20.2% (488 cases) being EOBCs and 79.8% (1930 cases) being LOBCs. The median age at diagnosis was 34.66 (IQR: 5.55) in the EOBC group (< 40 years) and 54.29 (IQR: 16.86) in the LOBC group (≥ 40 years). Invasive carcinoma—No Special Type was the commonest tumour type with grade III tumours being the commonest in both categories of patients. Perineural invasion was the only statistically significant pathologic parameter with age. EOBC was associated with higher DCIS component (24.8% vs 21.6%), lower hormone-receptor-positive status (52.30% vs 55.70%), higher proliferation index (Ki-67 > 20: 82.40% vs 80.30%) and a higher number of involved lymph nodes (13.80% vs 9.00%). Triple-Negative Breast cancer (26.40% vs 24.30%) was the most predominant molecular subtype of EOBC. Conclusion EOBCs in our setting are generally more aggressive with poorer prognostic histopathological and molecular features when compared with LOBCs. A larger study is recommended to identify the association between relevant pathological features and early onset breast cancer in Ghana. Again, further molecular and genetic studies to understand the molecular genetic drivers of the general poorer pathological features of EOBCs and its relation to patient outcome in our setting is needed.

Objective. Mortality data from hospitals in Ghana suggest a changing mortality trend with noncommunicable diseases (cardiovascular disorders) replacing communicable diseases as the leading cause of death. Our objective was to find out the causes of deaths in the communities of the Central Region of Ghana and raise awareness of these causes of deaths while highlighting the differences that exist between data obtained from the community and that obtained from the hospital. Method. Mortality data from Coroner’s autopsies mostly provide data about the causes of deaths in the community (out of hospital). A retrospective descriptive study of Coroner’s autopsy data at the Cape Coast Teaching Hospital was carried out over a six-year period. The various causes of death were categorized according to broad headings (accidents/injuries/poisoning, cardiovascular, infections, metabolic, neoplasms, and others). Results. A total of 1187 autopsies were reviewed of which 990 (83.4%) were Coroner’s cases. Of these Coroner’s cases, 719 (72.6%) were male and 271 (27.4%) were female. 521 (52.6%) of victims were young adults (18–44 years), and majority of deaths were unnatural (due to accidents, injuries, and poisoning) (64.1%), followed by the general category of others (15.3%). Cardiovascular deaths (6.6%) were fourth after infections (9.8%). In the leading category, most deaths were due to road traffic accidents (50.4%) as occupants of vehicles and motorcycles (28.7%) and as pedestrians (21.7%). Deaths due to road traffic accidents were followed by deaths due to drowning (14.96%). Conclusion. Although noncommunicable diseases are still the leading causes of death outside the hospital, most of the deaths are due to road traffic accidents and drowning. This is at variance with hospital data that suggest that the leading noncommunicable diseases are cardiovascular disorders and cancer. Again, like data derived from hospitals, infections remain a major cause of death in the Central Region of Ghana. Studies combining the causes of death derived from Coroner’s autopsies and communities and from medical certificates of cause of death will present a better picture of the leading causes of death in the Central Region and reveal the true nature of noncommunicable diseases that currently form our largest disease burden.

Background Renal cell carcinoma (RCC) is a heterogeneous group of malignant epithelial tumors of the kidney. It accounts for more than 90% of all kidney cancers. However, papillary RCC is the second most common histologic subtype representing 10–15% of all RCCs. The mean age of presentation for papillary RCC ranges between 59 and 63 years but more importantly when RCC is diagnosed at a younger age, the possibility of an underlying hereditary kidney cancer syndrome should be considered. RCC potentially metastasizes to many different organs with lung being the commonest site accounting for 45.2%. The treatment for metastatic RCC is mostly multimodal for most patients. However, patients with untreated pulmonary metastases have been observed to have very poor prognosis with a 5-year overall survival rate of only 5% or even less and thus the need to report on the unusual outcome of our patient who had a metastatic disease. Case presentation The present study reports a papillary renal cell carcinoma with multiple lung metastases in a 31-year-old woman who presented with progressive right flank mass and pain with no chest symptoms. She underwent cytoreductive radical nephrectomy via a right subcostal incision. Patient, however, did not undergo metastasectomy nor palliative systemic therapy and was seen 5 years post-nephrectomy. Conclusion Our patient with metastatic RCC, without undergoing metastasectomy nor palliative systemic therapy, remained stable with 5-year progression-free survival post-cytoreductive nephrectomy.

Background Immunohistochemistry is an invaluable technique used clinically in the characterisation of breast cancer in various intrinsic subtypes. Such characterisation into the intrinsic subtypes is of great prognostic value in the management of breast cancer. Methodology Two hundred and seventy-six cases of formalin-fixed paraffin-embedded (FFPE) tissue blocks were selected from 2012–2016 cases from Korle Bu Teaching Hospital (KBTH). The hormonal markers Estrogen Receptor (ER), Progesterone Receptor (PR), HER 2 and Ki67 were determined for cases using a semi-automated immunohistochemical method with commercially prepared antibodies from BioSB. Results The commonest intrinsic molecular subtype is luminal type A (42.2%), luminal B (12.3%), Her 2+ (10.5) and TNBC (35.0%). There is a significant association between tumour size and all the intrinsic subtypes (P < 0.05). The luminal type A and B were associated with size < 5 cm while TNBC was associated with size ≥ 5 cm. Ki67 was unfavourable for 65.5% of the cases with 21.8% favourable and 12.7% being borderline. The various subtypes are significantly associated with vascular invasion. Discussion and conclusion This study has shown that a greater percentage of breast cancer among Ghanaian patients are hormonal positive and should have done well on hormonal treatment but did not because of the late presentation and tumour characteristics. The study confirmed previous results of the higher incidence of TNBC in African women as compared to other ethnic groups.

Background Breast cancer is the leading cause of cancer morbidity and mortality worldwide. The management and prognosis of breast cancer depend heavily on the different histologic and molecular biologic features of the tumour. The different histologic types describe the distinct growth patterns and cytological features of the tumour.   Methodology This is a retrospective study of archival breast cancer excision and mastectomy specimen at KBTH from 2012-2016. 729 cases were retrieved over the period and examined by two pathologists independently. Demography of the cases, tumour size, grade, histologic type, stage, mitosis, site of lesion etc. were entered into SPSS and analysed with chi-square done with P-value set at P < 0.05.   Results and Conclusion The mean age of presentation is 52.45 ± 12.75 years. The commonest histologic type of breast cancer is invasive carcinoma (NOS) forming (87%). Only 1.2% of male presented with breast cancer with the other percentage in females. Most (88%) of the tumours were greater than 5cm at the time of surgery. The tumours are of high grade (II and III) forming 88%. Seventy-eight percent of cases presented with late stage of the disease (≥ stage IIB). There was association between histologic type and vascular invasion (P < 0.000) and lymph node involvement (P = 0.010). Moreover, tumour size showed an association with tumour grade (P < 0.05). This study has shown that breast cancer among Ghanaian patients has a worse histologic type with poor tumour characteristics giving it poor prognosis.