Background. Nearly 70% of women diagnosed with breast cancer in Ghana are in advanced stages of the disease due especially to low awareness, resulting in limited treatment success and high death rate. With limited epidemiological studies on breast cancer in Ghana, the aim of this study is to assess and understand the pattern of breast cancer distribution for enhancing early detection and treatment. Methods. We randomly selected and screened 3000 women for clinical palpable breast lumps and used univariate and bivariate analysis for description and exploration of variables, respectively, in relation to incidence of breast cancer. Results. We diagnosed 23 (0.76%) breast cancer cases out of 194 (6.46%) participants with clinically palpable breast lumps. Seventeen out of these 23 (0.56%) were premenopausal (<46.6 years) with 7 (0.23%) being below 35 years. With an overall breast cancer incidence of 0.76% in this study, our observation that about 30% of these cancer cases were below 35 years may indicate a relative possible shift of cancer burden to women in their early thirties in Ghana, compared to Western countries. Conclusion. These results suggest an age adjustment for breast cancer screening to early twenties for Ghanaian women and the need for a nationwide breast cancer screening to understand completely the pattern of breast cancer distribution in Ghana.

BackgroundGestational diabetes is a risk factor for perinatal complications; include shoulder dystocia, birth injuries such as bone fractures and nerve palsies. It is associated with later development of type 2 diabetes, the risk of macrosomia and other long-term health effects of infants born to diabetic mothers. The study assesses placental peptides and maternal factors as potential predictors of gestational diabetes among pregnant women.Material and methodsA total of 200 pregnant women were recruited for the study, 150 pregnant women without pre gestational diabetes including 50 women with low risk factors of diabetes as controls and 50 other pregnant women with pregestational diabetes as control. Fasting blood glucose and the lipid profile were determined by enzymatic methods using Envoy® 500 reagents (Vital Diagnostics, USA). Glycated haemoglobin was assessed using the Cation Exchange resin method. Leptin and the Human Placenta Lactogen were assayed using the Sandwich-ELISA technique. Beta chorionic gonadotrophin, insulin, progesterone and estradiol were determined using chemilumiscence imunoassay technique on MAGLUMI 600 analyzer. Anthropometry, including BMI and blood pressure were also measured.ResultsFasting plasma glucose (FBG), insulin, insulin resistance, glycated haemoglobin and Human Placenta Lactogen(HPL)were significantly (p<0.0001) increased in the pregestational diabetic women whereas progesterone and estradiol were significantly decreased. In the second trimester however, there was no significant difference (p>0.05) in estradiol, insulin, insulin resistance and HPL between the pregnant women who developed gestational diabetes and those who did not. Leptin, progesterone and FBG were significantly increased in those who developed GDM. The risk of developing gestational diabetes increased with overweight (OR = 1.76, P = 0.370) and family history of diabetes (OR = 2.18, P = 0.282).ConclusionLeptin, progesterone, estradiol estimated in this study were increased in the gestational diabetes mellitus women and fairly predicted gestational diabetes in the non-diabetics pregnant women. Obesity, aging and family history of diabetes were strongly predictive of gestational diabetes.

Background What cheaper alternative breast screening procedures are available to younger women in addition to clinical breast examination (CBE) in Sub-Saharan countries? In 2009, we first described BreastLight for screening and reported high sensitivity at detecting breast cancer. Due to limitations of BreastLight, we have since 2014 been using the more technologically advanced Breast-i to screen 2204 women to find cheaper screening alternatives. Methodology First, the participant lies down for CBE and then, in a darkened room, Breast-i was placed underneath each breast and trained personnel confirm vein pattern and look out for dark spot(s) to ascertain the presence of suspicious angiogenic lesion(s). Results CBE detected 153 palpable breast masses and Breast-i, which detects angiogenesis, confirmed 136. However, Breast-i detected 22 more cases of which 7 had angiogenesis but were not palpable and 15 were missed by CBE due to large breast size. Overall confirmed cases were 26, with Breast-i detecting 7 cases missed by CBE. Breast-i and CBE gave sensitivities of 92.3% and 73%, respectively. Conclusion Breast-i with its high sensitivity to angiogenesis, reliability, and affordability will be an effective adjunct detection device that can be used effectively to increase early detection in younger women, thereby increasing treatment success.

Background: People with primary invasive breast cancer receive both local (surgery and radiation therapy) and systemic treatment (chemotherapy and hormonal therapy). However, there are substantial short-and long-term side effects from chemotherapy as documented in several studies. This study assessed the effects of chemotherapy on clinical, haematological and biochemical profile of breast cancer patients undergoing chemotherapy in the Cape Coast Teaching Hospital. Methods: This longitudinal study was conducted in the female surgical ward of the Cape Coast Teaching Hospital (CCTH). We randomly sampled 51 patients diagnosed with breast cancer and scheduled to start chemotherapy and recorded their demographic, clinical and therapeutic data. Blood was collected for haematological profiles [haemoglobin (Hb), white blood cell (WBC) count, platelets (PLT) and biochemical analysis (lipid profile, uric acid and creatinine) for day 1, day 21 and day 42 of their chemotherapy cycles. Results: Majority of the participants were within 46-60 years, married, overweight and had informal employment. Throughout chemotherapy cycles, systolic blood pressure (SBP) significantly decreased till after the third cycle (P=0.026), diastolic blood pressure (DBP) significantly decreased after second cycle but increased slightly after the third cycle (P=0.029). Hemoglobin though insignificant, decreased after the second cycle but increased sharply after the third cycle (P=0.281). White blood cells (WBC) significantly decreased throughout cycles (P=0.008) whereas high density lipoprotein (P=0.014) increased throughout cycles- Uric acid (P=0.852) and creatinine (P=1.000). were maintained throughout cycles Conclusion: Throughout cycles, chemotherapy had significant adverse effect on the clinical profile (systolic and diastolic blood pressure), white blood cells (WBC) and high density lipoprotein (HDL) in patients undergoing treatment.

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