Patient age at diagnosis and the clinicopathological features of breast cancer in women

BackgroundBreast cancer (BC) is diagnosed commonly in younger Ghanaian women compared to women in western countries.AimsThe aim of this study was to compare the clinico-pathological features of BC in young women (≤39 years) with older women (≥40 years) and draw conclusions.Methods This was a retrospective review (2001–2014).Results Approximately 19.6per cent of the study population were women aged ≤39 years (Group A). Bilateral BCs were commoner in group A compared to B (women aged 40 years or older), [(1.1per cent vs. 0.6per cent), (p=0.002]. About 60.7 per cent of group A had skin involvement compared to 71.3 per cent for B, (p=0.002). About 75.7 per cent of group A women presented with breast lumps after 3 months of onset (late), compared to 70.1 per cent of group B women (p=0.000). The mean size of primary BC for A was 5.6cm compared to 5.1cm for B, (p=0.004). Positive tumour margins were found in 27.7 per cent of BCs in A and 24.2 per cent in B, (p=0.003). Grade 3 tumours were common in group A than B [(35.8 per cent vs. 31.0 per cent), p=0.002]. Approximately, 70.5 per cent group A women had positive nodes compared to 88.8 per cent of group B (p=0.001). Higher TNM stages were found in group A compared to B [(58.1 per cent vs. 51.1 per cent, p=0.033)].ConclusionThe study found that 19.6 per cent of the women were age 39 years or younger. Features of advanced BC were common in younger women. Routine self-breast examination is recommended for all Ghanaian women to enhance early detection and management of neoplastic lesions

Single nucleotide polymorphisms in LCAT may contribute to dyslipidaemia in HIV-infected individuals on HAART in a Ghanaian population

© 2020, The Author(s). Highly active antiretroviral therapy (HAART) is known to cause lipid abnormalities such as dyslipidaemia in HIV-infected individuals. Yet, dyslipidaemia may not independently occur as it may be worsened by single nucleotide polymorphisms (SNPs) in lecithin cholesterol acyltransferase (LCAT) and lipoprotein lipase (LPL). This case–control study was conducted in three-selected hospitals in the Northern part of Ghana. The study constituted a total of 118 HIV-infected participants aged 19–71 years, who had been on HAART for 6–24 months. Dyslipidaemia was defined based on the NCEP-ATP III criteria. HIV-infected individuals on HAART with dyslipidaemia were classified as cases while those without dyslipidaemia were grouped as controls. Lipid profile was measured using an automatic clinical chemistry analyzer and genomic DNA was extracted for PCR (GeneAmp PCR System 2700). Overall, the prevalence of dyslipidaemia was 39.0% (46/118). High levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and reduced levels of high-density lipoprotein cholesterol (HDL-C) were observed in all cases. A total of 256 selected PCR amplicons comprising 137 LPL (exons 3, 5 and 6) and 119 LCAT (exons 1, 4, and 6) were sequenced in 46 samples (Inqaba Biotech). Six (6) clinically significant SNPs were identified in exons 1 and 4 for LCAT whereas 25 non-clinically significant SNPs were identified for LPL in exons 5 and 6. At position 97 for LCAT exon 1, there was a deletion of the nucleotide, ‘A’ in 32.5% (13/40) of the sampled population while 67.5% (27/40) of the sample population retained the nucleotide, ‘A’ which was significantly associated with dyslipidaemic outcomes in the study population (p = 0.0004). A total of 25 SNPs were identified in exons 5 and 6 of LPL; 22 were substitutions, and 3 were insertions. However, none of the 25 SNPs identified in LPL exon 5 and 6 were statistically significant. SNPs in LCAT may independently contribute to dyslipidaemia among Ghanaian HIV-infected individuals on HAART, thus, allowing genetic and/or functional differential diagnosis of dyslipidaemia and creating an opportunity for potentially preventive options

Follicular Thyroid Carcinoma in a Country of Endemic Iodine Deficiency (1994–2013)

Background. Follicular thyroid cancer (FTC) has historically been linked to iodine deficiency. Although Ghana is among the iodine deficient regions of the world, the proportions, trends, and the clinical features of FTCs have not been studied as a single disease entity. The aim of this study was to determine the relative frequencies, trends, and the clinicopathological characteristics of FTCs among all thyroid malignancies in our institution. Materials and Methods. This was a retrospective study from January 1994 to December 2013. Data were analysed using SPSS software version 23 (Chicago) and Graph pad prism version 5.00. Results. Follicular thyroid cancer was the second thyroid malignancy (35.0%) and showed a gradual rise in relative proportions over the period. The male-female ratio was 1 : 1.5. The mean ages were 46.9 (SD ±17.3) for males and 46.4 (SD ±13.3) years for females. Enlarged palpable anterior neck swelling was the commonest symptom in males (86.7%) and females (91.3%) (P=0.730). Hurthle cell carcinoma was the commonest variant of FTC, with 26.7% males and 10.6% females (P=0.116). Distant spread was found in 23.3% of males compared to 19.1% of females (P=0.633). The common sites of distant spread were bones (57.2%) in males and cervical lymph nodes (44.4%) in females (P=0.106). Conclusion. Follicular thyroid cancer was the second common thyroid malignancy (35.0%) with a gradual rise in trend over the study period and male-female ratio of 1.5 : 1. Large anterior neck swelling was the commonest clinical presentation of FTC