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The Prognostic Significance of the Size of Primary Malignant Breast Tumour in Ghanaian Women: A Retrospective Histopathological Review (2001-2014) in the Department of Pathology, Korle-Bu Teaching Hospital (KBTH).

BACKGROUND
Previous studies on breast cancer (BC) in Ghanaian women found the disease to be common in young women who present late with large palpable tumours. The aim of this study was to determine how the size of a primary malignant breast tumour influences the prognosis of BC in Ghanaian women.


MATERIAL AND METHODS
A retrospective review of BCs diagnosed in mastectomy and wide local excision biopsy specimens with axillary clearance were conducted. Primary malignant breast tumours were categorised based on the size (cm) into: tumour d" 2.0cm (T1), tumour >2.0 d" 5.0 cm (T2) and tumour > 5.0 cm (T3). Data were analysed using SPSS version 23 (Chicago). Associations between tumour variables were determined by Spearman's correlation coefficient and Fisher's exact test (GraphPad prism version 5).


RESULTS
The mean size of primary malignant breast tumours was large (5.8±3.8cm). Approximately half were T3 tumours. The mean ages of women diagnosed with T1, T2 and T3 tumours were: 51.5 ±2.0, 52.8±12.4 and 51.2 ±12.7 years, respectively. High grade BCs (II and III combined), involvement of 4 or more positive lymph nodes by malignant cells, high TNM stage and increased prevalence of positive malignant tumour margins were all significantly high in T3 tumours (P<0.0001) compared to T1 and T2 tumours. There were significant associations between T2 tumours and the histological subtype (p- = 0.011) and nodal involvement (p = 0.044) by malignant cells. Similarly, T3 tumours showed significant positive association with the histological subtype (p = 0.019) and nodal involvement (p = 0.018).


CONCLUSION
The study found large primary tumour size (T3) to show significant positive association with the histological subtype and lymph nodes involvement by tumour. T3 tumours also showed increased prevalence of positive tumour margins.