Female Breast Cancer in Northern Ghana: A Retrospective Histo-Pathological Study at the Department of Pathology of the Tamale Teaching Hospital (TTH) (2012 to 2021)

Abstract

Background: Data on breast cancer (BC) in northern Ghana is scant. The aim of this study was to provide data on the clinicopathological, prognostic and molecular characteristics of BC in females of northern Ghana. Methods: Data on breast cancer patients (n = 1,913) in the Department of Pathology of the Tamale Teaching Hospital (TTH) was collected from 1st January, 2012 to 31st December, 2021 and analysed at four levels: introduction, clinicopathological features, prognostic stratification using the NPI score and the molecular subtypes of BC based on IHC Status. Associations between variables were determined by Fisher’s exact test. Results: There were 1,191 (62.3%) benign and 722 (37.7%) malignant tumors. A gradual rise in the relative proportions of the female BCs over the period was observed. The mean age (years) of BCs diagnosed in small to medium size samples was 47.7±16.0, and 36.4% were aged <40 years. The commonest clinical presentation of BC was a palpable breast lump (65.5%). Majority of the BC patients presented 3 months after the onset of the illness. Invasive ductal carcinoma was the commonest subtype of BC (78.0%), and the great majority (93.1%) had a combined (II & III) high histological grade (P<0.0001). Stratifying women diagnosed with BC into prognostic categories using the NPI, 15.4% had excellent prognosis, compared to 49.2% with poor prognosis. Conclusion: The study identified breast cancer as a common breast disease among women in the study area with advanced clinico-pathological features at presentation, and therefore, poor prognosis even at the time of diagnosis.