AUTHOR=Ssentongo Paddy , Oh John S. , Amponsah-Manu Forster , Wong William , Candela Xavier , Acharya Yubraj , Ssentongo Anna E. , Dodge Daleela G. 

TITLE=Breast Cancer Survival in Eastern Region of Ghana

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.880789

DOI=10.3389/fpubh.2022.880789

ISSN=2296-2565

ABSTRACT=Objective: Five-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 a rural community setting in sub-Saharan Africa. 
Methods: We performed a retrospective medical review of patients undergoing surgery and chemotherapy for breast cancer at a regional hospital in Ghana from January 2014 through January 2017. Descriptive and survival analysis was done. 
Results: One hundred and twenty-nine patients were included in the study. The median age at presentation was 51 years. 60.0% 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%.  
Conclusion: The cumulative 3-year survival was 52 %. Despite success in reducing cancer mortality in southern and northern Africa, survival in the rural communities of 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.