Background: Genetic counselling and testing is neither accessible nor affordable to the general population of most women living with a breast cancer diagnosis in low and middle income countries like Ghana. Triple negative breast cancer; a more aggressive subtype of breast cancer is very prevalent in black women yet most of the women diagnosed do not get genetically tested. Breast cancer mortality is very high which means a large amount of genetic data is being missed currently until genetic testing is implemented soon.  

Objective: To explore feasible and sustainable strategies for implementing accessible and affordable genetic counselling and testing for breast cancer patients in Ghana, with the aim of integrating these services into holistic breast cancer care, addressing the genetic data gap; particularly for triple-negative breast cancer and informing clinical practice and policy to benefit patients and their families.

Methods: The question: How can genetic counselling and testing be implemented in Ghana as a part of holistic breast cancer care that is accessible and affordable and benefits patients and their families whilst bridging our genetic data gap. 

Results: Healthcare personnel are ready to be trained in cancer genetics and genetic counselling with some hospitals already making use of online trainings. There are in country laboratory institutions able to offer genetic testing to cancer patients in Ghana. Genetic counselling and testing is expensive and will be an out of pocket payment for the patient.   

Conclusion/Implications for practice or policy: There are still a lot of advanced breast cancer diagnosis in Ghana and this means quite a lot of patients may not benefit from genetic testing as they may not have a long survival time. The quality of genetic test reports depends on the quantity and quality of genetic data pool available so we need to develop protocols on testing advanced patients who qualify for genetic testing and still make it beneficial to them and their families without the financial burden. Culturally mastectomy is not a preferred operation choice, so what happens in cases where women have a genetic mutation when a mastectomy or bilateral mastectomy may be the recommended clinical advice. Infrastructure must be in place to secure genetic data and enable patient/patient family tracing when their mutation gets recategorized.