Abstract
BACKGROUND: Breast cancer (BC) continues to be the leading cancer diagnosis and top cancer-related mortality globally among women globally including Ghana. Late stage reporting of breast cancer at health facilities is pervasive and largely attributed to patronage of traditional or herbal medicines practitioners (TMPs) prior to seeking orthodox treatment. However, there is a scarcity of research examining BC knowledge, perceptions and treatment practices among TMPs in Ghana. OBJECTIVES OF THE STUDY: The objectives of this study were to assess the level of BC knowledge among TMPs, determine level of TMPs involvement in BC treatment, examine TMPs BC treatment practices, and determine strategic approaches that can be employed to bridge the gap between TMPs and conventional oncologists to facilitate early reporting and diagnosis of breast cancer among women in Ghana. METHODOLOGY: A cross-sectional study was conducted. The data were collected via a structured questionnaire using KOBO toolbox. Data was done using Stata version 17. Descriptive and inferential statistics were run on categorical variables. Logistic regression was used to predict factors that determined knowledge, perceptions, and referral of BC patients to hospitals among TMPs, and significant associations were set at a p value of 0.05. Variables with p values less than or equal to 0.05 were considered significant. The results are presented in tables and graphs. RESULTS: With a mean age of 50.8 years (M = 50.82, SD = 11.74), majority of the 170 participants are female (64.7%), literate (62.3%), and Akan (35.3%). Large majority (74%) of TMPs have treated clients with BC. While awareness of symptoms and risk factors was high, significant knowledge gaps existed with only 54% demonstrating good knowledge of BC while 46% showing poor BC knowledge. Ethnicity ( AOR = 5.3,p = 0.041) and regional affiliation (AOR = 0.05, p = 0.04) were strongly associated with BC knowledge; with Ewe ethnicity having good BC knowledge and TMPs in Northeast region scoring the lowest on BC knowledge. Majority (59.3%) of TMPs had positive perceptions of BC, with having a bachelor’s degree (AOR = 9.5, CI:1.8–49.4, P = 0.005), being a member of Ghana National Association of Traditional Healers (AOR = 12.4, CI: 1.8–83.6, P = 0.00), and being based in Northeast Region (AOR = 123.5, CI: 4.4–3615, P = 0.00) were strongly associated with positive perceptions towards BC. Belonging to Ewe ethnicity (AOR = 5.7, CI:0.9–32.5, P = 0.05) was associated with referral of BC cases to hospital while being based in Northeast region was less likely to refer BC cases to hospitals. There were unverifiable claims of curing BC patients. TMPs reported willingness to collaborate to promote early BC reporting and diagnosis. CONCLUSION: TMPs in Ghana are deeply involved in BC treatment, have positive perceptions towards BC, but lack comprehensive knowledge of BC. Collaborating with TMPs in BC awareness campaigns, training, and treatment planning is necessary for preventing late-stage presentation and improving BC treatment outcomes in Ghana. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-026-05337-y.