Breast cancer is the most common cancer among women in Ghana and a leading cause of cancer mortality. The source article emphasizes that a large proportion of cases are diagnosed at advanced stages, with delayed presentation driven by structural gaps in formal health services and sociocultural health-seeking behaviors. Traditional medicine—including herbalists and faith healers—is deeply embedded in Ghanaian communities and frequently functions as the first point of contact for women with breast symptoms.
This study aimed to explore how non-formally trained traditional medicine practitioners (TMPs) in Kumasi understand breast cancer: their sources of knowledge, beliefs about causation and risk, recognition of cardinal signs, and diagnostic and treatment practices. The intent was to inform culturally appropriate interventions, training, and referral systems to improve early detection and reduce delays.
The authors used an exploratory, descriptive qualitative design with in-depth, semi-structured interviews. The study took place in Kumasi, within the Kumasi Metropolitan Assembly. Participants were non-formally trained TMPs—herbalists and faith healers—who provided breast health services in their communities.
Eligibility required at least one year of experience in breast health or cancer care, community recognition as a TMP, proficiency in Twi or English, and willingness to participate. Formally trained traditional practitioners were excluded. Purposive sampling recruited participants through the Traditional Medicine Practice Council (TMPC) and community links. Fourteen TMPs were interviewed; the sample size was determined by data saturation, reached by the 12th interview with two additional interviews to confirm saturation.
Semi-structured interviews were conducted, transcribed, and translated as needed. The transcripts underwent thematic analysis to capture patterns in how TMPs recognize and interpret breast symptoms, explain causes and risks of breast cancer, and apply diagnostic and treatment approaches. Ethics approval and formal permissions for recruitment were obtained, and the dataset supporting the article is available in a public repository as reported by the authors.
Participants described multiple knowledge sources. Traditional inheritance and apprenticeship within families and communities remained primary. TMPs also reported efforts to improve skills through workshops, engagement with professional associations, and occasional collaborations or contact with biomedical providers. These activities indicate a willingness among some TMPs to learn and adapt new information, though the extent and content of such training varied.
TMPs expressed a blend of explanatory models. Some accounts attributed breast disease to spiritual or social disharmony—factors such as curses, sorcery, or moral transgressions—leading to spiritual treatment approaches. Others mentioned reproductive and lifestyle factors and, in some narratives, hereditary or biomedical explanations. The coexistence of spiritual, social, and biomedical ideas produced a heterogeneous belief landscape, and the authors note that important misconceptions persisted among many participants.
TMPs identified several key signs used to recognize breast disease: palpable lumps, changes to the nipple (discharge, inversion, bleeding), and skin alterations (ulceration, dimpling, discoloration). These signs were widely recognized, but interpretation of their severity and implications often incorporated spiritual or non-biomedical meaning. As a result, similar physical findings could prompt divergent responses—from herbal or spiritual remedies to referrals—depending on the practitioner’s beliefs.
Diagnosis was largely experiential and practice-based. TMPs relied on inspection and palpation, patient histories, observation of symptom patterns, and accumulated clinical experience. Intuition and spiritual/divinatory practices were also described. The authors highlight that these approaches carry the risk of both over-diagnosis (labeling benign conditions as cancer) and under-diagnosis (missing or minimizing signs that require biomedical evaluation).
The study frames TMPs as central actors in Ghana’s breast cancer pathway—both as potential gatekeepers who could facilitate early recognition and referral, and as barriers when misconceptions or spiritual framings delay biomedical care. Because non-formally trained TMPs are commonly consulted first, their diagnostic logic and communication can strongly influence patient trajectories. The authors argue that excluding these practitioners from cancer control strategies represents a missed opportunity.
The authors conclude that TMPs occupy a pivotal role and that correcting misconceptions, expanding structured training, and establishing referral linkages could reduce diagnostic delays and support national cancer control objectives. Integrating non-formally trained TMPs into culturally grounded training and referral systems may leverage their community legitimacy to promote earlier detection and appropriate biomedical care.