Triple-negative breast cancer among ghanaian women seen at Korle-Bu teaching hospital

Background. Women with African ancestry in the United States and in continental Africa have been found to have exceptionally increased frequencies of triple-negative breast cancer (TNBC); prompting speculation that this risk may have an inherited basis and may at least partially explain breast cancer outcome disparities related to racial/ethnic identity. Our goal was to evaluate the breast cancers diagnosed in one of the largest health care facilities in western Africa; and to compare the frequencies as well as risk factors for TNBC versus non-TNBC. Methods. We reviewed all breast cancer cases that had immunohistochemistry (Novolink Detection system); in 2010. Results. The overall study population of 223 breast cancer cases was relatively young (median age 52.4?y); and most had palpable tumors larger than five centimeters in diameter. More than half were TNBC (130 cases; 58.3%). We observed similar frequencies of young age at diagnosis; stage at diagnosis; and tumor grade among cases of TNBC compared to cases of non-TNBC. Conclusion. Ghanaian breast cancer patients tend to have an advanced stage distribution and relatively young age at diagnosis. The triple-negative molecular marker pattern is the most common seen among these women; regardless of age; tumor grade; and stage of diagnosis. Additional research is necessary regarding the causes of TNBC; so that we can elucidate the reasons for its increased prevalence among women with African ancestry

Positive tumor margins in wide local excision of breast cancer: a 10-year retrospective study

Background. The safety of wide local excision as a standard surgical option for early stage breast cancer management in Ghana has not been evaluated. The aim of this study was to use retrospective histopathological descriptive study to evaluate the prevalence of positive tumor margins in wide local excision specimens and offer recommendations. Study design. We reviewed 147 breast lumps; following wide local excision; which were received in the Department of Pathology; for positive tumor margins. The data was analyzed using SPSS software (version 16). Results. A total of 2;751 female breast cancers were diagnosed during the study period; of which 147 (5.3%) were from wide local excisions (lumpectomies). Thirty-one (21.0%) had positive tumor margins. The mean age of women with positive margins was 53.4 (SD = 17.1) years. The mean size of primary tumor was 4.0 (SD = 2.1) cm; the majority (53.0%) of which were greater than 2.0?cm; but less than or equal to 5.0?cm (T2). A total of 26 (83.4%) of these tumors were invasive ductal carcinomas (NOS); 24 (92.3%) of the cases had combined Bloom-Richardson grading; and many; 10 (41.7%); were grade 1. Conclusion. Our study shows that 21.0% of all wide local excision biopsies had positive tumor margins; a figure that is comparable to those of other studies. Tumors with positive margins in this study were large; 4.0?cm (T2); and common in relatively young women. Treatment failure is therefore likely to occur in these patients

Colorectal Carcinoma: an Update of Current Trends in Accra

BACKGROUND: Clinical experience and earlier studies indicate that the number of colorectal cancer cases seen annually in the Accra metropolis is increasing. OBJECTIVE: This study was aimed at providing a current update on colorectal cancer in Accra; Ghana. METHODS: A prospective study of confirmed cases of colorectal cancer diagnosed from January 1997 - December 2007. RESULTS: Three hundred and fifty-nine colorectal cancer cases were studied. Males were 192(53.5) and females 167(46.5) with an annual incidence of 32.6 new cases. The crude incidence rates were 12.53; 9.87 and 11.18 per 100;000 population for males; females and overall respectively. Rectal bleeding 185(51.1); abdominal mass 76(21.1); intestinal obstruction 62(17.3); intestinal perforation nine (2.5) and iron deficiency anaemia nine (2.5) cases were the main presentations. There were 168 (46.8) rectal and 191(53.2) colon tumours. Two hundred and thirty-one patients had laparotomy with 225 resections; and 128 patients for various reasons did not undergo surgery. The Astler Coller stages of the tumours at diagnosis were C2 84(36.7); C1 53(22.1); B2 49(21.4); D 17(7.4); B1 14(6.1) and A 12(5.1) cases. Adenocarcinoma was the commonest histological type 321(89.4); with the majority either well-differentiated (62.5) or moderately well-differentiated (25.6) carcinomas. Poorly differentiated carcinomas accounted for 28 cases (7.8). Post-operative mortality was 6.1. Long term survival could not be assessed as the majority of patients were lost to follow up. CONCLUSION: The incidence of colorectal cancer has increased over the last four decades in tandem with an aging population of Accra with adenocarcinoma as the predominant histological type