The pattern of presentation, management and outcome of breast cancer patients at a tertiary health facility in Sierra Leone

Abstract

Background Breast cancer is the leading cause of cancer among women globally and the most common cancer amongst women in Sierra Leone. The aim of this study was to evaluate the patterns of clinical presentation, management and outcome among breast cancer patients who presented at the Connaught Teaching Hospital Complex in Sierra Leone. Method A retrospective, cross-sectional study was conducted at the specialist outpatient clinic at the Connaught Hospital. The medical records of 253 breast cancer patients were selected through a convenience sampling based on completeness of their data from 2018 to 2021. Patient's socio-demographic, obstetrics-gynaecological history, clinic-pathological characteristics, treatment modalities and outcomes were analysed by SPSS version 24. Results Of the 253 breast cancer patients, 246 (97.2%) were female and the mean age of the patients was 47±14 years. The mean age at menarche was 12±3 years and 35 (13.8%) of patients had a family history of breast cancer. The left breast 130 (51.2%) was the most commonly affected; about 119 (47%) of patients presented with stage III B and 35 (13.8%) with metastasis at presentation. With regards to treatment modalities, a combination of surgery, chemotherapy, and hormonal were provided to the patients, with 25.2 (48%) mastectomies, 98 (20.5%) hormonal therapy, 35 (7.3%) palliative care and about 8 (15.2%) refused treatment. The outcomes of breast cancer patients showed the highest mortality was in 2019, 19 (32.8%) and the least was in 2018, 10 (27.8%). Conclusion Our study showed that over half of our patients presented in advanced stage and mastectomy was the most common modality of treatment. There is a need to promote public health awareness on early presentation to improve patient’s outcome.