Affiliations: [a] Department of Epidemiology, University of Michigan School of Public Health, Omaha, NE, USA | [b] College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA | [c] Central Administration, Komfo Anokye Teaching Hospital, Omaha, NE, USA | [d] Department of Medical Oncology and Radiation, Komfo Anokye Teaching Hospital, Omaha, NE, USA | [e] Department of Pathology, Komfo Anokye Teaching Hospital, Omaha, NE, USA | [f] Department of Surgery, Komfo Anokye Teaching Hospital, Omaha, NE, USA | [g] Department of Internal Medicine, University of Michigan, Omaha, NE, USA
Correspondence:
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Corresponding author: Amr S Soliman, University of Nebraska Medical Center, College of Public Health, 984395 Nebraska Medical Center, Omaha, NE 68198, USA. Tel.: +1 402 559 3976; Fax: +1 402 559 7259; E-mail: amr.soliman@unmc.edu
Abstract: BACKGROUND:Cancer rates are increasing in Africa, including Ghana. Breast cancer is the second most common cancer in incidence and mortality in Ghana. OBJECTIVE:We outlined both breast cancer patient characteristics and management at the Komfo Anokye Teaching Hospital (KATH), the main cancer management hospital in central Ghana. Moreover, we identified the treatment interventions predictive of patient outcome. METHODS:Medical records of 597 breast cancer patients seen in 2008–2011 were abstracted to investigate management and treatment patterns. Abstracted variables included type and extent of surgery, number and cycles of chemotherapy and radiotherapy, as well as the course of treatment completed. RESULTS:Late stage at diagnosis was common, treatment plans of the study hospital were relatively standardized according to disease severity, and defaulting/interrupting treatment in the records was also common. Patients diagnosed with late stage cancer who received adjuvant therapy and patients with hormone status evaluation were more likely to have complied with treatment guidelines and continued oncotherapy at the study hospital than those who never had hormone status requested or reported. CONCLUSIONS:Our study lends support to improving patient outcomes in low- and middle-income countries through raising knowledge and reporting of tumor hormonal status and providing appropriately tailored treatment. Achieving improved outcomes should also consider enhancing public understanding of the importance of early detection and completion of treatment.
Keywords: Breast cancer, health systems navigation, developing countries (LMIC), Ghana
DOI: 10.3233/BD-140372
Journal: Breast Disease, vol. 34, no. 4, pp. 139-149, 2014
