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

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 BuTeaching hospital (KBTH). Method: A prospective study of the characteristics of breast cancer patients seen by a surgical unit atKBTH over a three year period. Results: There were 158 patients, 156 females and 2 males. The age group most commonly affectedwas 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 durationof 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, 15during 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

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

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 BuTeaching hospital (KBTH). Method: A prospective study of the characteristics of breast cancer patients seen by a surgical unit atKBTH over a three year period. Results: There were 158 patients, 156 females and 2 males. The age group most commonly affectedwas 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 durationof 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, 15during 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

BREAST CANCER RISK IN PATIENTS WITH BREAST PAIN IN ACCRA, GHANA

Objective: To determine the risk of breast cancer in patients presenting with breast pain in Accra,Ghana.Design: Retrospective clinical study.Setting: A self-referral breast clinic in Accra, Ghana.Subjects: Patients with breast pain as a presenting complaint, between January 2001 and December2005.Interventions: Patients were investigated by triple assessment.Results: There were 447 patients with pain, 322 as the only symptom and 125 in addition to othersymptoms like breast lump and nipple discharge. Patients with pain only were found to have nodetectable abnormality 203 (63%) and fibroadenosis 78 (24.2%) as the most common diagnoses.Breast cancer was found in four (1.24%) of them, all of whom had abnormality on clinical breastexamination. In patients with pain as well as other symptoms the common diagnoses werefibroadenosis 25 (20%), breast cancer 20 (16%) and normal 18 (14.4%).Conclusion: The risk of breast cancer is significantly higher in patients presenting with breast painin addition to other symptoms, compared to patients with breast pain as the only symptom (16%and 1.24% respectively P<0.0001). Patients with breast pain should always have breast examinationand not simply reassured. Women should be encouraged to do breast self examination