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Ghana Breast Health Study: A Multidisciplinary Case-control Study in West Africa

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Female breast cancer is one of the most common malignancies in the United States. Certain types of breast cancer are more common among younger African American and Black women, compared with non-Hispanic White women. Hormone-negative breast cancers occur more frequently in women with West African ancestry compared to European and even other African ancestries. By studying risk among West African women, we hope to discover the contribution of genetic, lifestyle, and other risk factors to breast cancer in this population. The study findings will inform cancer control programs in Ghana, and other low and middle-income countries as well as improve prevention in the US. The study should provide a wealth of data to inform our knowledge of the epidemiology of breast cancer in African women.

    Read more about our research on breast cancer, risk modeling, and breast cancer tumor characteristics. 

    Study Team

    Lead Investigators

    Mustapha Abubakar, M.D., Ph.D, 
    Earl Stadman Investigator, Integrative Tumor Epidemiology Branch

    Jonine Figueroa, Ph.D., M.P.H. 
    Senior investigator, Integrative Tumor Epidemiology Branch

    Collaborating Institutions in Ghana

    Korle Bu Teaching Hospital, Accra

    Komfo Anokye Teaching Hospital, Kumasi

    Peace and Love Hospital, Kumasi

    Background & Purpose

     The Ghana Breast Health Study aims to identify genetic, lifestyle, and environmental risk factors for breast cancer in Ghanaian women and assesses whether risk factor associations vary by clinical and molecular tumor characteristics. The study also builds capacity for future research investigations in Ghana. 

    The main aims are to:

    • Identify factors that predispose to the development of breast cancer among Ghanaian women;
    • Identify genetic and other biologic factors predictive of risk;
    • Assess how these risk factors vary by clinical and molecular characteristics of the tumors Study Summary 

    Study Design

    We recruited approximately 2,000 cases and 2,000 population controls from three hospitals in Ghana: Korle Bu Teaching Hospital in Accra; Komfo Anokye Teaching Hospital, and Peace and Love Hospital in Kumasi. Population controls were randomly selected from the same residential areas as cases are expected to derive. Exposure information was obtained through detailed personal interviews and anthropometric measurements. Breast tissue samples were collected prior to treatment and preserved to enable accurate immunohistochemical characterization of tumor subtypes. Blood, saliva, and fecal samples were also collected to enable the assessment of genetic risk markers, microbiome characteristics, and other possible biomarkers.

    Select Findings & Publications

    Preliminary data showed a relatively high prevalence of exposure to some novel risk factors (e.g., 25 percent of participants reported use of skin lighteners, some of which contain hormonal constituents).

    Brinton LA et al. Design considerations for identifying breast cancer risk factors in a population-based study in Africa. Int J Cancer. 2017. 

    Brinton LA et al. Skin lighteners and hair relaxers as risk factors for breast cancer: results from the Ghana breast health study. Carcinogenesis 2018.

    Ahuno ST et al. Circulating tumor DNA is readily detectable among Ghanaian breast cancer patients supporting non-invasive cancer genomic studies in AfricaNPJ Precis Oncol. 2021.