Abstract PR01: Breast cancer in Ghana: A study of the characteristics of breast cancers reported nationally from 2018 to 2020
Authors: Akakpo Kafui , Aduse-Poku Livingstone , Fernando Kurt , Edusai Lawrence , Naporo Simon , Fossi Sabrina I. , Antwi Sylvester , Jiagge Evelyn M. 
Published: December 2020

Abstract
Introduction According to GLOBOCAN 2018 data, breast cancer (BC) is the leading cancer in women and the second cause of cancer mortality. Most BC studies in Ghana and other nations in the Sub-Saharan African regions have revealed that these BC are very aggressive and have poor prognostic features. However, previous studies on the clinical and pathological characteristics have been limited to data from single institutions and have used smaller sample sizes. Here we are reporting on the data from a pathology lab (Pathologists Without Borders) that serves patients from each of 16 regions of Ghana that are representative of more than 50% of the BC patients seen over the span of two years; this is due to the unique ability to sustain immunohistochemistry services for an entire year. Objectives The objective of this study is to more accurately report the clinical and histological characteristics of BC across the country to determine the distribution by age and subtype to better understand the relationship between West sub-Saharan African ancestry and aggressive triple negative BC. Methods With ethical approval, demographic, clinical and pathology data on patients with histological diagnosis of BC between 5/1/18 and 5/14/20 at participating healthcare facilities in Ghana were entered into a database. Immunohistochemistry for the estrogen receptor, progesterone receptor, and human epidermal growth factor (HER2) is based on the bio-SB semi-automated platform. A descriptive analysis on variables such as age, clinical diagnosis, tumor size, number of lymph nodes, tumor grade, and BC subtypes was performed. A comparative analysis of the various variables was done using IBM Statistical Package for Social Sciences (SPSS) for windows, version 26.0 at 5% confidence interval. Results A total of 1741 BC cases with a mean age of diagnosis, 51.70 ± 16.68 were included in the study. BC was diagnosed most frequently in patients ≥50 years (41.5%) and occurred more frequently on the left side (45.7%). The majority of BC were &lt;1000g (61.7%), &gt;5cm in size (67.8%) had no lymph nodes involvement (35.8%) and were grade II (49.7%). 32.0% of the patients were triple negative. Triple Negative Breast Cancers (TNBCs) were more frequently diagnosed in patients &lt;40 years old (41.2%) who had T3 tumors (30.6%) that was &lt;1000g (37.9%), &gt;5cm in size, grade III (49.5%), and had &gt;10 lymph nodes involved N3 (33.3%). Conclusion TNBCs and HER2+ tumors are the most frequently diagnosed BC in Ghana. The majority of the tumors present with aggressive features such as premenopausal diagnosis, large size, high grade, and have more lymph node involvement. This data is more representative of the characteristics of BC across the country. Here we demonstrate the importance of a standardized pathology reporting system across the country. Research should be carried into the molecular pathology of Ghanaian BC to ascertain reasons for high number of aggressive forms.
Citation Format: Kafui Akakpo, Livingstone Aduse-Poku, Kurt Fernando, Lawrence Edusai, Simon Naporo, Sabrina I. Fossi, Sylvester Antwi, Evelyn M. Jiagge. Breast cancer in Ghana: A study of the characteristics of breast cancers reported nationally from 2018 to 2020 [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PR01.