Breast Cancer Survival in Eastern Region of Ghana

Abstract

ObjectiveFive-year overall survival rate of breast cancer in low-income countries (LICs) is significantly lower than in high-resource countries. This study explored clinical and pathological factors influencing mortality in the Eastern region of Ghana.MethodsWe performed a retrospective medical chart review for patients undergoing surgery and chemotherapy for breast cancer at a regional hospital in Ghana from January 2014 to January 2017. Descriptive and survival analysis was done.ResultsOne hundred and twenty-nine patients were included in the study. The median age at presentation was 51 years. Sixty percent of patients presented with poorly differential histological grade III. The most common histological type was invasive ductal carcinoma (83%). Based on stage assessment using only tumor size and lymph node status, 60% presented at stage 3. Only 25% were tested for hormone receptor proteins and HER2 status. Of these, 57% had triple-negative breast cancer (TNBC). The 3-year overall survival rate was only 52%.ConclusionThe cumulative 3-year survival was 52%. Despite success in reducing cancer mortality in northern Africa, survival in sub-Saharan Africa remains poor. A significantly higher percentage of GIII and TNBC is found in breast cancers seen in Ghana. When combined with limited capacity for accurate diagnosis, cancer subtype analysis, adequate therapy, and follow-up, late-stage presentation leads to poor outcomes. Future studies should emphasize the identification of barriers to care and opportunities for cost-effective and sustainable improvements in diagnosing and treating breast cancer in LICs.

Survival Patterns Among Patients With Breast Cancer in Sub-Saharan Africa

“…More than two-thirds of the studies were published after 2010. Thirty-one studies (63.3%) included only female participants, while the remaining studies included both female and male (30.6%) or only male (6.1%) participants . The proportion of female participants was higher in the studies that included both sexes.…”

“…Following a thorough full-text review, 69 studies were reviewed. Of these, 49 studies that met the eligibility criteria were included in the narrative synthesis, and 40 of them underwent meta-analysis for a more in-depth and comprehensive analysis (Figure 1).…”

“…Of 49 studies included in the systematic review, 13 were conducted in Nigeria; 4 each in Ethiopia and South Africa; 3 each in Sudan, Ghana, Uganda, and Burkina Faso; 2 each in Kenya, Malawi, Cameroon, Senegal, and multiple countries; and 1 each in Gambia, Zimbabwe, Tanzania, Mozambique, Congo, and Guinea . More than two-thirds of the studies were published after 2010.…”

“…Following a thorough full-text review, 69 studies were reviewed. Of these, 49 studies that met the eligibility criteria 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 were included in the narrative synthesis, and 40 of them 20 , 21 , 22 , 23 , 25 , 27 , 29 , 30 , 31 , 32 ,…”

“…Of 49 studies included in the systematic review, 13 were conducted in Nigeria 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ; 4 each in Ethiopia 33 , 34 , 35 , 36 and South Africa 37 , 38 , 39 , 40 ; 3 each in Sudan, 41 , 42 , 43 Ghana, 44 , 45 , 46 Uganda, 47 , 48 , 49 and Burkina Faso 50 , 51 , 52 ; 2 each in Kenya, 53 , 54 Malawi, 55 , 56 Cameroon, 57 , 58 Senegal, 59 , 60 and multiple countries 61 , 62 ; and 1 each in Gambia, 63 Zimbabwe, 64 Tanzania, 65 Mozambique, 66 Congo, 67 and Guinea. 68 More than two-thirds of the studies were published after 2010.…”