Breast Cancer Care in Ghana: A Review of the Continuum of Care and Progress Toward Universal Health Coverage.

INTRODUCTION: Breast cancer is the most prevalent cancer among women in Ghana, and improving outcomes requires coordinated progress across the continuum of care. This review synthesizes current evidence on breast cancer care in Ghana, including screening and diagnosis, treatment availability and utilization, survivorship, financial and transportation considerations, sociocultural determinants, and emerging innovations. METHODS: A narrative literature review was conducted using iterative topic-based searches across PubMed and Google Scholar, supplemented by searches on Google.com for Ghana-based programs and on ClinicalTrials.gov for clinical trials. Ninety-nine sources that were published in 2011-2026 and met relevance criteria were included. Secondary chi-square and univariate logistic regression analyses of the 2022 Ghana Demographic and Health Survey examined associations between breast cancer screening and socioeconomic/geographic factors. Geographic heatmaps were created to illustrate regional variation in diagnostic and treatment service availability. RESULTS: Screening and diagnostic imaging services are increasingly available but concentrated in urban centers, highlighting regional access opportunities. Pathology service shortages hinder timely diagnosis and subtyping, though ongoing investments in diagnostic infrastructure represent progress. Treatment services-including surgery, systemic therapy, and radiation-are available at select centers nationwide, and continued expansion should improve outcomes as earlier detection increases. Despite high national insurance enrollment, screening and treatment coverage gaps persist, underscoring the need for capacity building and policies to reduce financial burden and improve care continuity. Sociocultural beliefs and awareness shape health-seeking behavior, making community-based education key to early detection and treatment adherence. Ghana is growing capacity in emerging areas of breast cancer care, including genetic counseling and testing, fertility preservation, and clinical trial participation, which, although not widely available, may enhance patient outcomes. CONCLUSION: These findings highlight progress and opportunity in Ghana's breast cancer care landscape, underscoring the value of investing in decentralized services, workforce development, capacity building, and patient-centered strategies for equitable breast cancer care nationwide.