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 1 st January 2002 to 31 st 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.

Survival status and predictors of mortality among Breast Cancer patients in Adult Oncology Unit at Black Lion Specialized Hospital, Addis Ababa, Ethiopia, 2018

“…In this 6-year retrospective follow up study, the overall survival rates at 1, 3, and 5 years were, 97.2%, 80.8%, and 46.2% respectively. This finding is consistent with other previous studies which have been conducted in Malaysia (70.8%, 56.9% and 49.4%) (23) and Ghana, (47.9%) (17) .However, this finding is higher than those in other African countries in Tanzania (21.8%) (24) and Cameroon (30%) (25) at 5 years and even lower than previous results in Uganda (51.8 %) (26), and Vietnam, (94%, 83% and 74%)(4).This ,figure is still lower when compared with that of studies of high income countries such as Northwest Iran (96%, 86%, and 81%), Germany( 83% ),and the Qidong(83.61%,67.53%,and58.75%)respectively (27)(28)(29).…”

“…This finding is in agreement with different studies conducted in African countries (17,32) ,and also in the study done in Iran (33) ,in which lymph node status was an important determinant of survival. Despite being positive lymph node status, as the number of involved lymph nodes increases, so does the relapse rate, while the survival rate decreases.…”

“…Clinical stage at diagnosis was assigned to each patient by using the American Joint Committee on Cancer TNM classification scheme for staging breast cancers was used (17).In this research, the coding for those diagnosed at stages I and IV remained. Stages IIA and IIB were collapsed as stage II, and stages IIIA, IIIB and IIIC were collapsed as stage III.…”

“…According to World health organization estimation, an age standardize incidence case of breast cancer in Ethiopia were 12,956 and mortality rate of breast cancer were 25 per 100 000 women respectively (14) .As a result, to avert this burden currently the Ethiopian Federal Ministry of Health (FMOH) prepared a task force to address the issue of non-communicable diseases particularly with especial emphasis on cancer .One of the fundamentals parts of the strategic framework is to reduce the incidence and mortality of cancer and improve the quality of life of cancer patients (15). Despite the extensive knowledge about incidence and survival rates for cancer in the western world, cancer survival data is not widely available from countries in Africa, and Asia (16,17).Breast cancer is the most common cause of cancer deaths among women in developing countries particularly in SSA and survival tends to be poor in this region because of a combination of a late stage at diagnosis and limited access to timely and standard treatment (18) .Despite, the government concern on the issue of non-communicable diseases with especial emphasis on cancer, in order to reduce the incidence and mortality, the survival status of breast cancer patients still were not known in Ethiopia particularly at the BLSH. In line with the strategy, this study aimed to assess the survival status and its predictor of mortality among breast cancer patients at Black Lion specialized hospital, Addis Ababa, Ethiopia, 2018.…”

Expression of Tumour-Associated MUC1 Is a Poor Prognostic Marker in Breast Cancer in Kumasi, Ghana

“…Consequently, survival among African women with breast cancer is much lower compared to that of Whites, with as low as 13.6% in Gambia [20]. In line with the lower rates particularly in sub-Saharan Africa, a recent study on survival outcomes of breast cancer in Ghana demonstrated that the overall 5-year survival was 47.9% [21].…”