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

SUMMARY

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 Bu Teaching hospital (KBTH).

METHOD: A prospective study of the characteristics of breast cancer patients seen by a surgical unit at KBTH over a three year period.

RESULTS

There were 158 patients, 156 females and 2 males. The age group most commonly affected was 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 duration of 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, 15 during 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.