Breast cancer treatment and outcomes at Cape Coast Teaching Hospital, Ghana.

Objectives: This study sought to determine the presentation, treatment and outcomes of breast cancer among women in Cape Coast, Ghana. Design: Retrospective medical record review. Setting: Cape Coast Teaching Hospital, Cape Coast, Ghana. Participants: Female breast cancer patients. Interventions: None. Main outcome measures: Proportion of female breast cancer patients presenting with advanced disease. Results: Approximately 84% of women had a primary presentation of breast cancer, with metastatic disease present in 34% of patients. Surgical management mainly involved partial mastectomy (21.7%) and total mastectomy (78.6%), with the most common postoperative complications being surgical site infections (3.8%). Non-surgical management involved chemotherapy, radiation therapy and anti-estrogen therapy, with Stage 3 and 4 patients twofold more likely to receive neoadjuvant chemotherapy than earlier stages (OR= 2.0 95% CI (1.4, 3.0, p<0.001). Grade 1 cancers were diagnosed in 11.0%, Grade 2 in 43.8%, and Grade 3 in 45.2%. The mean cancer size was 6.5 centimetres (range 1.5 to 20.0). Lymphatic vascular invasion was present in 59/125 (47.2%), estrogen receptor status was positive in 32.6%, progesterone receptors were positive in 22.1%, and Her-2/neu was positive in 32.6%. Triple-negative breast cancer was identified in 41/89 (46.1%). Conclusions: Women with breast cancer typically present to the Cape Coast Teaching Hospital with advanced stage disease and experience poor outcomes. Funding: Funding for this study was provided by the Harvard Medical School Scholars in Medicine.