Determinants of Late Presentation and Histologic types of Breast Cancer in Women Presenting at a Teaching Hospital in Kumasi, Ghana

Abstract

Introduction: Breast cancer is the most common malignancy in women and the leading cause of cancer deaths worldwide. In Ghana and many parts of Africa more than 50% of breast cancer patients present with advanced stage even though evidence suggests that health education on breast cancer has intensified. Objectives: To determine the socio demographic characteristics of women presenting with breast cancer, pattern of presentation and the association between patients demographic characteristics and stage of presentation. Methods: A prospective cross-sectional study over a period of three months was conducted at the Breast clinic of Komfo Anokye Teaching Hospital, Kumasi, Ghana. Women with histological diagnosis of breast cancer were interviewed using a structured questionnaire. Results: Fifty women with breast cancer were studied with ages between 27 and 75 years with peak between 40-49 years. Majority presented three months after noticing the first symptom, usually a breast lump. Twenty nine (58%) women presented with late stage breast cancer. The commonest histologic type 44(88%) was invasive ductal Carcinoma. There was a strong positive correlation between stage of breast cancer and place of residence (0.4496) but a weak positive correlation between stage of breast cancer and age (0.1684), as was also stage of breast cancer and marital status (0.1143). There was a negative correlation between level of education and stage of presentation (-0.3398). Conclusion: Breast Cancer is common in 40-49 age groups. The incidence of late stage breast cancer is 58% with majority presenting within 7-12 months of onset of first symptoms, mostly breast lumps with invasive ductal carcinoma as the most common histologic type in stage 3. Fear of mastectomy was the main reason for late presentation. Most patients had some knowledge on breast cancer mostly from the radio stations. The stage of Breast cancer was strongly associated with patients’ level of education, residence (distance from facility) and religion.