Background/Objectives: Breast cancer incidence is increasing in younger Ghanaian women. However, few epidemiological studies have evaluated the modifiable risk factors in this population. Additionally, these studies have classified breast cancer in Ghanaian women based on the global menopausal case classification. This study reclassified premenopausal and postmenopausal breast cancer in a Ghanaian cohort, assessing the risk factors using the observed menopausal age in Ghanaian women of 48 years, rather than the global standard of 50 years. Methods: Women diagnosed with breast cancer and scheduled for surgery from December 2018 to March 2023 were recruited across four hospitals in Ghana for the Ghana Breast Cancer Omics Project (BCOPGh), and data were collected using a questionnaire. Cross-tabulation and linear regression were used to evaluate the relationships between categorical variables and age at diagnosis. Results: Out of a total of 262 women recruited, 34.4% were classified as having premenopausal breast cancer, while early-onset breast cancer (EOBC) accounted for 14.9% of all cases. The molecular subtypes were predominantly hormone receptor (HR)-positive (61%) while triple-negative breast cancer (TNBC) accounted for 16%. The tumours were predominantly at stage II (62%) and grade 2 (51%), with invasive carcinoma NST (56%) being the most common subtype. Within this cohort, nulliparity increased the odds of EOBC by 13.5-fold, while having a first birth after the age of 23 doubled the odds of premenopausal breast cancer. Reproductive factors (menarche and menopause) and lifestyle (alcohol intake, smoking, contraceptive use, and breastfeeding duration) were not associated with premenopausal breast cancer in this cohort. About 13% of participants reported a family history of breast cancer, and 79% had prior knowledge of the disease. Conclusion: This study supports previous reports of the relatively higher incidence of aggressive disease in young Ghanaian women and the protective effect of early age at first birth. It further underscores the need to investigate its genetic underpinnings, whilst highlighting the importance of public education on self-examination techniques to reduce advanced disease presentation in Ghanaian women.
背景/目的：加纳年轻女性乳腺癌发病率呈上升趋势，但针对该人群可调控风险因素的流行病学研究较为有限。现有研究多依据全球通用的绝经期分类标准对加纳女性乳腺癌进行分类。本研究采用加纳女性实际观察到的48岁绝经年龄（而非全球通用的50岁标准）对加纳队列中的绝经前与绝经后乳腺癌进行重新分类，并评估相关风险因素。方法：通过加纳乳腺癌组学计划（BCOPGh），在加纳四家医院招募2018年12月至2023年3月期间确诊并计划手术的乳腺癌患者，采用问卷调查收集数据。运用交叉表与线性回归分析分类变量与诊断年龄的关联性。结果：在招募的262名女性中，34.4%被归类为绝经前乳腺癌，早发性乳腺癌占全部病例的14.9%。分子分型以激素受体阳性为主（61%），三阴性乳腺癌占16%。肿瘤分期以II期（62%）为主，组织学分级以2级（51%）居多，非特殊型浸润性癌是最常见的亚型（56%）。在该队列中，未生育使早发性乳腺癌风险增加13.5倍，而首次分娩年龄超过23岁会使绝经前乳腺癌风险翻倍。生殖因素（初潮与绝经年龄）及生活方式（饮酒、吸烟、避孕药使用、母乳喂养时长）与绝经前乳腺癌无显著关联。约13%的参与者报告有乳腺癌家族史，79%的患者在确诊前已具备疾病认知。结论：本研究证实了既往关于加纳年轻女性侵袭性乳腺癌发病率相对较高的报道，并验证了早育的保护作用。研究结果进一步强调需深入探索其遗传学基础，同时凸显了通过公众教育推广乳房自检技术对降低加纳女性晚期乳腺癌发生的重要性。
肿瘤(癌症)患者之家