Profile of breast diseases at a self-referral clinic in Ghana.
BACKGROUND
Breast cancer is a common malignancy in Ghana, and many patients are referred with advanced disease and long duration of symptoms.


OBJECTIVE
To determine the spectrum of breast disease diagnosed through patient self-referral in Ghana.


METHODS
A breast clinic, where patients could walk in without referral, was started in the Korle Bu Teaching Hospital in 2001. A team of surgeons, radiation oncologists, oncology nurses, a clinical psychologist and a clinical pharmacist sat in conference once a week to see and discuss self-referred patients.


RESULTS
Seven hundred and forty eight patients, mean age 38.6 (range 8-85) years, were seen during a four-year period. There were 741 females and seven males. The main complaints were pain 450 (50.2%), lump 257 (28.7%) and nipple discharge 62 (8.3%). Fifty (5.6%) came for check-up; 139 (18.6%) had more than one complaint. The mean (S.D.) duration of symptoms was; for nipple discharge 14.1 (10.5) months, lump 11.9 (7.7) months, and pain 11.3 (8.9) months. The main diagnoses were: Normal breasts 192 (27.7%), mastalgia 135 (18.1%), fibroadenosis 114 (15.2%), fibroadenomas 84 (11.2%), breast cancer 58 (7.8%), suspected breast cancer 25 (3.3%), galactorrhea 9 (1.2%), mastitis 8 (1.1%), musculoskeletal pain 8 (1.1%), duct ectasia 8 (1.1%), mondor's disease 7 (0.94%) and recurrent breast cancer 6 (0.8%). In patients with breast cancer, 42 (66%) had advanced disease, 6 (9.4%) had recurrent disease and 4 (63%) had metastatic disease.


CONCLUSIONS
The number of self-referrals, detected breast cancers and duration of symptoms justify the need for self-referral clinics in Ghana.
Clegg-Lamptey
J N A
JN
Department of Surgery, Korle Bu Teaching Hospital, Accra, Ghana. clegglamptey@hotmail.com
Aduful
H K
HK
Yarney
J
J
Adu-Aryee
N A
NA
Vanderpuye
V
V
Kyereh
M
M
Nkansah
A
A
Edwin
A
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001941:Breast Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult