A study of breast cancer in korle bu teaching hospital: assessing the impact of health education

Abstract

SUMMARY INTRODUCTION: Many patients with breast cancer report late with advanced disease. It is not known if recent breast awareness education programmes have led to a change in this trend at the Korle Bu Teaching hospital (KBTH).METHOD: A prospective study of the characteristics of breast cancer patients seen by a surgical unit at KBTH over a three year period.RESULTS: There were 158 patients, 156 females and 2 males. The age group most commonly affected was 40-49. The upper outer quadrant of the breast was affected in 67/158 (42.4%) and all quadrants affected in 29/158 (18.4%). Ninety one (57.6%) had Stage III - IV disease and the average duration of symptoms was 10 months. Average tumour size was 6cm x 7cm. Diagnosis was by triple assessment with Fine needle aspiration cytology the most frequently used pathological investigation. Invasive ductal carcinoma was the commonest pathological type (115/134). Eighty three (52.5%) had mastectomy and 12 (7.6%) had wide local excision. Neoadjuvant chemotherapy was given to 77/123 (62.6%), 5 of whom had complete pathological response. Fifty five (34.8%) were lost to follow up: 20 before treatment commenced, 15 during or after neoadjuvant chemotherapy and 14 after treatment. Eleven developed lymphoedema. There were 42 metastatic events affecting 35 patients during follow-up, including pleura (11), brain (10) and lungs (9).CONCLUSIONS: Breast cancer continues to affect a young population and patients still present late with advanced disease. Education needs to be intensified, but research into the reasons for late presentation will help address the reasons/misconceptions responsible for this state of affairs.