Mensah Samuel, Kyei Ishmael, Agbedinu Kwabena, Shiako Joshua, Yorke Dennis Afful, Gyedu Adam
Department of Surgery, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
Department of Surgery, University Hospital, KNUST, Kumasi, Ghana.
JCO Glob Oncol. 2025 May;11:e2400653. doi: 10.1200/GO-24-00653. Epub 2025 May 5.
The WHO's Global Breast Cancer Initiative (GBCI) described three key performance indicators (KPIs) to reduce breast cancer deaths worldwide. We assessed the management of breast cancer in Ghana against the GBCI KPIs to inform necessary steps for system-wide improvement.
We reviewed patients diagnosed with breast cancer in 2021 calendar year at Ghana's second largest tertiary hospital. Relevant data were extracted from the electronic medical records to determine the stage of breast cancer at diagnosis, duration to confirm diagnosis from initial presentation, and proportion of patients completing recommended treatment without abandonment. Data were presented as descriptive statistics and compared with GBCI KPI benchmarks.
Of 319 patients undergoing biopsy of suspicious breast lesions, 243 were diagnosed with breast cancer. Most (98.7%) were female, with a median age of 49 years and median symptom duration of 24 weeks. Diagnosis was confirmed for all patients within 31 days of initial presentation. Only 22 of 214 patients (10.3%) undergoing staging were diagnosed as early breast cancer (stage I or II), 50% at stage III, and 39.3% at stage IV. Forty-five of 139 patients (32.4%) initiating recommended treatment completed without abandonment, and 45 of 243 patients (18.5%) with a confirmed breast cancer completed recommended treatment without abandonment.
Ghana met the GBCI KPI for timely diagnosis (<60 days of presentation) but fell short in early detection (≥60% early breast cancer) and treatment completion without abandonment (>80%). Our findings provide baseline data for planning system-wide improvements toward the GBCI's goal of reducing breast cancer mortality by 2.5% annually.
世界卫生组织的全球乳腺癌倡议（GBCI）描述了三项关键绩效指标（KPI），以减少全球乳腺癌死亡人数。我们对照GBCI的KPI评估了加纳的乳腺癌管理情况，为全系统改进的必要步骤提供依据。
我们回顾了2021年在加纳第二大三级医院被诊断为乳腺癌的患者。从电子病历中提取相关数据，以确定诊断时乳腺癌的分期、从初次就诊到确诊的时间，以及完成推荐治疗且未中断治疗的患者比例。数据以描述性统计呈现，并与GBCI的KPI基准进行比较。
在319例接受可疑乳腺病变活检的患者中，243例被诊断为乳腺癌。大多数（98.7%）为女性，中位年龄49岁，中位症状持续时间24周。所有患者在初次就诊后31天内确诊。在214例接受分期检查的患者中，只有22例（10.3%）被诊断为早期乳腺癌（I期或II期），50%为III期，39.3%为IV期。在139例开始接受推荐治疗的患者中，45例（32.4%）完成治疗且未中断，在243例确诊乳腺癌的患者中，45例（18.5%）完成推荐治疗且未中断。
加纳达到了GBCI关于及时诊断（就诊后<60天）的KPI，但在早期检测（≥60%为早期乳腺癌）和完成治疗且未中断（>80%）方面未达标。我们的研究结果为规划全系统改进以实现GBCI每年将乳腺癌死亡率降低2.5%的目标提供了基线数据。
