Diagnostic Accuracy of Mammographic Findings in Patients 35 Years and Older Presenting with Palpable Breast Lump in University of Benin Teaching Hospital, Benin City.

BACKGROUND: Mammography has become an invaluable tool for diagnosing breast lesions and detecting early breast cancer in women of 35 years and above. AIMS: To correlate the mammography Breast Imaging Reporting and Data System (BI-RADS) categories with the histology in breast lesions and to determine the predictive values, sensitivity, specificity and accuracy of mammography. PATIENTS AND METHOD: This was a one- year prospective study carried out from March 2015 to February 2016. Consecutive female patients of 35 years and above with breast lesions at the University of Benin Teaching Hospital, Benin-City were recruited. Patients with fungating breast lesions and those who declined recruitment were excluded. All patients had mammography and core biopsy of the breast lesion which was examined histologically. RESULTS: A total of 101 patients were studied. Five patients had bilateral breast lesions making a total of 106 biopsies that were performed. The mean age of patients with benign breast disease was 47.0 ± 4.9 years while those with malignant breast disease was 49.9 ± 8.5 years; P-value was 0.080 which was not statistically significant. Fibrocystic disease 6 (5.6%) was the most common benign disease while invasive ductal carcinoma was the most common malignant breast disease 84(79.2%). BI-RADS 5 correlated mostly with malignant breast disease (97.0%); P value < 0.001 and was statistically significant. CONCLUSION: This study showed that mammography is useful in the diagnosis of breast lesions in women who are 35 years and older. Patients with BI-RADS category 3, 4 and 5 had an increasing correlation with malignant breast disease.

CONTEXTE: La mammographie est devenue un outil inestimable pour diagnostiquer les lésions mammaires et détecter précocement le cancer du sein chez les femmes de 35 ans et plus. OBJECTIFS: Corréler les catégories du Breast Imaging Reporting and Data System (BI-RADS) de la mammographie avec l'histologie des lésions mammaires et déterminer les valeurs prédictives, la sensibilité, la spécificité et la précision de la mammographie. PATIENTES ET MÉTHODE: Il s'agit d'une étude prospective d'un an réalisée de mars 2015 à février 2016. Les patientes consécutives de 35 ans et plus présentant des lésions mammaires à l'Hôpital Universitaire de Benin, à Benin-City, ont été recrutées. Les patientes présentant des lésions mammaires fungiques et celles qui ont refusé de participer à l'étude ont été exclues. Toutes les patientes ont subi une mammographie et une biopsie au trocart de la lésion mammaire, qui a été examinée histologiquement. RÉSULTATS: Un total de 101 patientes ont été étudiées. Cinq patientes présentaient des lésions mammaires bilatérales, soit un total de 106 biopsies réalisées. L'âge moyen des patientes atteintes de maladie mammaire bénigne était de 47,0 ± 4,9 ans, tandis que celui des patientes atteintes de maladie mammaire maligne était de 49,9 ± 8,5 ans ; la valeur P était de 0,080, ce qui n'était pas statistiquement significatif. La maladie fibrokystique 6 (5,6%) était la maladie bénigne la plus fréquente, tandis que le carcinome canalaire infiltrant était la maladie mammaire maligne la plus fréquente 84 (79,2%). Le BIRADS 5 corrélait principalement avec les maladies mammaires malignes (97,0%) ; la valeur P était < 0,001 et était statistiquement significative. CONCLUSION: Cette étude a montré que la mammographie est utile dans le diagnostic des lésions mammaires chez les femmes de 35 ans et plus. Les patientes ayant des catégories BI-RADS 3, 4 et 5 présentaient une corrélation croissante avec les maladies mammaires malignes. MOTS-CLÉS: Mammographie, Lésion mammaire féminine, Histologie, Corrélation, Précision diagnostique.

Intracystic papillary carcinoma of the breast in a Nigerian male: case report.

Intracystic papillary non invasive breast carcinoma is an extremely rare form of intraductal carcinoma constituting 5% of male breast cancer. The latter accounts for only 1% of all breast cancers. Until now, no case has been documented in an African male. This tumour was found in an 86 year-old male. It appeared benign on physical examination. Fine needle aspiration cytology was inaccurate. However, excisional biopsy in the form of total mastectomy with axillary clearance served to diagnose as well as treat the disease. This may be the first case of intracystic papillary carcinoma of the breast in the Nigerian male.

Breast Cancer in Young Nigerian Women

Breast cancer is rare in young women aged 30 and below. Out of a total of 374 patients admitted and managed for breast cancer in a period of 12 years; 14 (3.74) were aged 30 and below (mean 26.31 years); Their parity ranged between 0 and 4 (mean 1.5) and the duration of symptoms before presentation ranged between 3 weeks and 3 years. 6 cases involved the right breast; 4 the left and 3 were bilateral. All the patients presented with advanced breast cancer (stage 4 disease). Ten had invasive ductal Ca while one each had lobular carcinoma; lymphoma and malignant phyllodes tumour respectively. Management was multimodal: neovadjuvant chemotherapy; tamoxifen; mastectomy and referral for radiotherapy. Two developed features of depressive illness in the course of treatment; 6 died within 6 months of presentation; 1 after 3 months; 1 refused mastectomy discharged herself against in favour of traditional healers. The remaining 6 were lost to follow-up. It is confirmed that as else where; in Nigerians breast cancer in younger women is associated with a high degree of morbidity and mortality as well as physical and emotional stress

Paget's disease of the nipple-areola complex as seen in Benin City, Nigeria.

Out of a total of 240 patients who were managed at the University of Benin Teaching Hospital, Nigeria, for breast cancer over a ten year period (January 1995-December 2004, 8 (3.3%) were found to have Paget's disease of the nipple-areolar complex. They were all females aged between 38-60 (mean 47.62 years). Duration of symptoms before presentation was between 5 months and 7 years (mean 20.75 months). The left breast was more affected than the right. They all presented with itching, excoriation and ulceration of the nipple and diagnosis was by wedge biopsy of the nipple in early cases and by incisional biopsy in late cases. Most presented with advanced disease. Seven patients had mastectomy while one declined surgery. They all had chemotherapy and tamoxifen. Five died within one year of surgery while the remaining three were lost to follow up. Paget's disease, though rare, requires a high index of suspicion for proper diagnosis.

Management of enterocutaneous fistulae in Benin City Nigeria.

We report a prospective study of 17 cases of enterocutaneous fistulae managed at the University of Benin Teaching Hospital, Benin City, Nigeria between June 1992 and June 1999. All the cases were iatrogenic in origin and all age groups (6 weeks to 68 years, mean 27) were represented. There were 10 males and 7 females. Emergency surgery for acute appendicitis and intestinal obstruction were the commonest causes. Management should be conservative initially but surgery should be resorted to if there is no significant improvement, particularly in circumstances where facilities for total parenteral nutrition are not available. A literature review has been carried out and measures to prevent the development of enterocutaneous fistula are outlined.