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Purpose: To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women., Methods: BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD., Results: Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors., Conclusions: In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Breast masses occur infrequently in children and adolescents. Most of these masses have proved that benign and conservative approach is the management of choice. Consequently, imaging has become crucial. The knowledge of the ultrasonographic features of childhood and adolescent breast masses is needed for age appropriate medical care., Aim: The aim of this study was to describe and document the ultrasonographic spectrum of breast masses in children and adolescents (0-19) years seen in the Ahmadu Bello University teaching hospital, Zaria., Materials and Methods: A 2-year retrospective review of breast sonograms of 25 consecutively presenting children and adolescents (3 males and 22 females) who had palpable breast masses. Ultrasound scans were performed with a Mindray Machine DC-8 using the linear transducer at 7.5-12 MHz transducer frequency. Histopathological confirmation of the solid masses was also obtained. The statistical analysis of the data collected was done using the SPSS software version 20 (SPSS Inc., Chicago, IL, USA)., Results: The patients were between 40 days and 19 years old (mean 14.8 years and standard deviation 4.1). The ultrasonographic findings were those of infections, benign tumoral lesions and pubertal endocrine changes. Overall, fibroadenoma was the most common mass, seen in 14 (56%) of the patients. Other findings were simple cysts, non-puerperal and puerperal mastitis, juvenile papillomatosis and normal glandular pubertal breast tissue. The three male patients had gynaecomstia, pseudogynaecomastia and cystic lymphangioma of the chest wall presenting as unilateral breast masses, respectively. There was no malignancy recorded in any of the patients., Conclusion: Ultrasonographically, benign masses predominate which is concordant with surgical findings. Familiarity with these features would obviate the need for unnecessary invasive procedures which should be reserved for only deserving cases., Competing Interests: None

Background: Breast disorders cause great anxiety for women especially when they occur in pregnancy because breast cancer is the most common cause of cancer related deaths in women. Majority of the disorders are Benign Breast Diseases (BBD) with various degrees of associated breast cancer risks. With increasing breast cancer awareness in Nigeria, we sought to determine the prevalence and characteristics of breast disorders among a cohort of pregnant women., Methods: A longitudinal study of 1248 pregnant women recruited in their first trimester- till 26 weeks gestational age consecutively from selected antenatal clinics (ANCs), in Ibadan, Southwest Nigeria. A pretested interviewer- administered questionnaire was used to collect information at recruitment. Clinical Breast Examination (CBE) using MammaCare® technique was performed at recruitment and follow up visits at third trimester, six weeks postpartum and six months postpartum. Women with breast disorders were referred for Breast Ultrasound Scan (BUS) and those with Breast Imaging Reporting and Data System (BIRADS) ≥4 had ultrasound guided biopsy. Statistical analysis was performed using Stata version 14., Results: Mean age of participants was 29.7 ± 5.2 years and mean gestational age at recruitment was 20.4 ± 4.4 weeks. Seventy-two participants (5.8%) had a past history of BBD and 345 (27.6%) were primigravidae. Overall, breast disorder was detected among 223 (17.9%) participants and 149 (11.9%) had it detected at baseline. Findings from the CBE showed that 208 (69.6%) of 299 breast disorders signs found were palpable lumps or thickenings in the breast, 28 (9.4%) were persistent pain, and 63 (21.1%) were abscesses, infection and mastitis. Twenty out of 127 (15.7%) participants who had BUS performed were classified as BIRADS ≥3. Lesions found by BUS were reactive lymph nodes (42.5%), prominent ducts (27.1%), fibroadenoma (9.6%), breast cysts (3.8%) and fibrocystic changes (2.5%). No malignant pathology was found on ultrasound guided biopsy., Conclusions: Breast lump is a major breast disorder among pregnant women attending antenatal clinics in Ibadan. Routine clinical breast examination and follow up of pregnant women found with breast disorders could facilitate early detection of pregnancy associated breast cancer in low resource settings.

Introduction: There has been no previous study to classify benign breast lesions in details based on histopathologically confirmed diagnosis in Bayelsa State, Nigeria. This study therefore aims to review all cases of benign breast lesions seen in all the three centres in Bayelsa State with histopathology services over a five year period for a comprehensive baseline data in our community for management, research and education., Methods: This is a multicentre retrospective descriptive study based on histopathological diagnosed benign breast lesions from January 2009 to December 2013. Archival results and slides on benign breast lesions were retrieved and analysed using simple statistical methods., Results: A total of 228 benign breast lesions (68.3%) were seen among 334 histopathologically diagnosed breast diseases. The male to female ratio was 19.7:1. Peak age incidence was the third decade (43%) with a mean age of 29.1years. Fibroadenoma was the most common benign breast disease (BBD) accounting for 45.6% of all the cases followed by fibrocystic change (23.1%). The mean ages of fibroadenoma and fibrocystic change were 23.1years and 31.1years respectively. Inflammatory breast lesions constituted 8.3%. We recorded only 2 cases (0.9%) of atypical ductal hyperplasia (ADH) with no case of atypical lobular hyperplasia (ALH) within the study period. Gynaecomastia (4%) was the main male breast lesion in the study., Conclusion: Benign breast diseases are the most common breast lesions in Bayelsa State. Fibroadenoma is the most common lesion followed by fibrocystic change. The incidence of atypical hyperplasia recorded was rather low in the state.

Background: The increasing awareness concerning breast cancer has led to significant interest in breast masses in general. As a result there is considerable interest in the clinicopathologic studies of breast masses in various populations., Objective: To study the clinicopathologic pattern of breast masses at a private health facility in Lagos, Nigeria., Method: The records of all patients who presented between January 1993 and December 2002 with breast lumps at the Lagoon Hospital Apapa were reviewed. Their biodata, clinical presentation and histopathological diagnosis were retrieved., Results: 189 consecutive patients were studied comprising of 180 females and nine males. The peak age incidence for benign disease was 21-30 years while it was 31-40 years for those with malignant masses. Majority (66.1%) presented with painless solitary lumps. 46 (77.2%) patients had benign lumps while 43 (22.8%) had malignant lesions. The commonest benign lesion was fibrocystic disease (47.9%) while infiltrating ductal carcinoma was the commonest pathological diagnosis in the malignant group (83.1%)., Conclusion: From this study benign breast masses outnumber malignant ones by more than 3:1 in this population. The commonest pathological diagnosis was fibrocystic disease in benign lesions and infiltrating ductal carcinoma for malignant masses.

Objective: To review the histology of breast biopsies carried out in our hospital with a view to designing management and preventive strategies., Patients and Methods: 179 patients who had breast biopsies over a five year-period (January 1999 - December 2003) were included in the study. The patients were sorted out from the records in both the casualty and main theatres of the hospital. The medical records from their case files were analysed in terms of age, sex and the histology of the tissue obtained on biopsy., Results: Benign breast lesions accounted for 73.2% with fibroadenoma constituting a greater percentage. Whereas benign breast lesions were most commonly encountered in the third decade of life, malignant lesions occurred most commonly in the fourth decade. After the age of 60, all the cases analysed were of the malignant variety., Conclusion: Young patients with breast lump should be encouraged to come for consultation as most of them are benign. However, any lump in a woman above 30 should be properly screened for cancer. Similarly, any patient who presents with a breast lesion after the age of 60 should be regarded as having breast cancer until proved otherwise.

Background: Diseases of the breast are common and include problems, related to pregnancy and lactation, abscesses and other inflammatory conditions, nonneoplastic proliferative disorders and neoplasms. No known previous histopathological analysis has been done in our setting to classify breast lesions. The purpose of this study is to review all cases of breast diseases seen in the department over a six-year period and to determine the pattern of histological diagnosis of breast diseases in our setting., Methods: This was a hospital based retrospective study where our bench record books were used to identify all the breast lesions after which the Haematoxylin and Eosin stained slides and the request cards were retrieved. The slides were reviewed based on the diagnostic criteria by Juan Rosai., Results: A total of 291 breast lesions were seen in the department. One hundred and seventy three (59.5%) of these were inflammatory non-neoplastic proliferative and benign neoplastic disorders, while 118 (40.5%) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7%) cases. Of all the malignancies, invasive ductal carcinoma was the most frequent (68.6%). Breast cancer was found most frequently in the 4th decade (32.2%), followed by the 5th decade (24.6%) of life., Conclusion: Female breast cancer was quite common in this study and most of our patients presented with advanced disease.

Objective: To characterize benign breast diseases in Eastern Nigeria and to highlight the age variations of these lesions as base line data., Methods: The Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Enugu caters for over 30 million African blacks and receives 2000 surgical pathology specimens yearly. Seven hundred and twenty-two benign breast specimens were analyzed over 5 years from 1st January 2000 to 31st December 2004, out of 1050 breast samples received., Results: Of 1050 breast specimens received, 722 (68.8%) were benign. Fibroadenoma was the most common lesion with 318 cases (44%), occurring at a mean age of 16-32 years. Next was fibrocystic changes with 165 cases (22.9%) at a mean age of 23-45 years. Normal breast in the axillary tail region was seen in 32 cases (4.4%), represented as no pathology, with a mean presentation age of 20-46 years. Low grade Phyllodes tumor had 28 cases (3.9%), presenting at an average mean age of 17-32 years. Lactating adenoma had 19 (2.6%) cases. Other lesions made up less than 3% each. Benign breast lesions peaked at the 20-24 age range and then declined. Most were females., Conclusion: Benign breast lesions occur more frequently than malignant breast lesions with a ratio of 2.3:1 and were presented 20 years earlier than their malignant counterparts. Fibroadenoma was the most common benign lesion followed by fibrocystic disease, similar to the findings in Western Nigeria. In Northern Nigeria, fibrocystic breast disease was more common.

Unlabelled: A prospective survey of 225 patients carried out over a period of 7years (1992 - 1999) to determine the pattern and outcome of benign breast diseases. Two hundred and seventeen (96.4%) were females and 8 males, with the age ranging from 14-63 years, mean 28.7 SD+10.6 years. The mean age for patients with fibroadenoma was 24 years and 31.6 years for fibrocystic disease of the breast. One hundred and ninety six patients (87.2%) presented with breast lumps or mass, non-menstrual cycle and menstrual cycle related pain in 39(17.3%) and 32(13%) patients respectively and nipple discharge in 60 patients (26.7%). Mean duration of symptoms was 0.91+0.64 years, 2 + 1.2 weeks for inflammatory lesions and 0.86 + 0.56 yers for benign tumours and also menstrual cycle related breast pain. Right side was involved in 162 patients (72%), 85(38%) left side and 77(34.2%) bilateral. Clinical diagnosis was fibrocystic disease 96(42.7%). Fibroadenoma 89 (39.5%), inflammatory conditions 35(15.7%), galactocele in 9(40%) and gynaecomastia in 7(3%) of the patients. Excisional or incisional biopsy was carried out in 197 patients (87.5%), antibiotic and analgestic administration in 35(15.6%) and 29(13%), respectively. Histopathologic analysis showed fibroadenoma in 91 (46.2%), fibrocystic disease 83 (42.2%), and others in 23 (11.6%) cases. The mean follow-up period was 10 months for tumours and I month for others. Postoperative complications were infrequent, there were recurrence either on the ipsilateral or contralateral breast in 10(4.4%) patients of which 3(1.3%) cases were malignant., Conclusion: Fibroadenoma was the most common benign breast disease, followed by fibrocystic disease of the breast. Postoperative complications were uncommon.

This review of 299 cases of breast abscesses seen over a 10-year period (1981-1990) at the University of Calabar Teaching Hospital in Nigeria seeks to establish the current status of breast abscesses in the tropics. Lactational breast abscess constitutes 95% of breast abscesses while non-lactational breast abscess constitutes only 5% in this review. The commonest pathogen cultured from lactational breast abscess is Staphylococcus aureus and the disease responds to incision and drainage and systemic antibiotics, while non-lactational breast abscess is caused mostly by anaerobic organisms, usually with underlying mammary duct ectasia. The low incidence of non-lactational breast abscess corresponds to the low incidence of cigarette smoking and mammary duct ectasia in Nigerian women. While the high incidence of lactational breast abscess corresponds to the high rate of breast feeding and low level of personal hygiene in the low income group Nigerian women in which the disease is commonest. Economic recession has also reduced patronage of artificial feeds thus intensifying breast feeding and consequent lactational breast abscess.

In the Igbos of Nigeria, most adolescent breast masses were due to gynecomastia in males and to fibroadenoma in females. The peak ages for both diseases differed from those reported in a recent American series. An exotic finding was a mammary mass due to onchocerca worms. Curiously, there were as many as two cases of a rare tumor, namely, alveolar soft part sarcoma.

A review of 52 unselected cases of benign breast masses operated on at the University College Hospital Ibadan, showed that fibroadenoma was the most common benign lesion found, followed by fibrocystic disease of the breast. Fibroadenoma is most common in the second and third decades of life, usually in nulliparous young women, whereas fibrocystic disease is most common in the fifth decade, usually in parous women. Benign breast lesions are more common in the left breast than the right, and the most common location is the upper outer quadrant.

Experience with benign breast disorders has been analyzed in 3 nonwestern populations: Hong Kong, India, and Northern Nigeria. Similarities to and differences from Western experience are found, but of great interest are notable differences between these populations which, as yet, lack explanation. All show "fibroadenosis" and fibroadenoma as common conditions, but the frequency with which phylloides tumor is diagnosed varies between different centers in India as well as between different racial groups. Tuberculosis is another interesting example--wide differences in the frequency of breast infection are found although tuberculosis itself is common in all 3 countries. The value of prospective studies was shown when mastalgia was studied in this way in India. Often considered a "Western" affliction, these authors have been able to study 112 cases of mastalgia and found it to be twice as common as cancer as a presentation. These differing experiences between populations have been little explored and must hold promise for unravelling some of the enigmas of benign breast disorders in all countries.

For the purpose of defining the distribution of breast diseases in Nigeria, a review of 671 cases seen in Ife over a 10 year period was undertaken. Twenty-six (3.9 per cent) of the patients were males. The frequency of breast diseases in this population was fibro-adenoma, 48 per cent; carcinoma, 21 per cent; breast abscess, 8.6 per cent; fibrocystic disease, 5.5 per cent; sclerosing adenosis, 5.4 per cent and gynaecomastia, 2.7 per cent. The other breast lesions were the same type of disease as documented in white patients. The most striking difference was the relatively high incidence of fibro-adenoma, especially in nulliparous adolescent females, while carcinoma and fibrocystic disease were fewer than expected. Breast carcinoma presented a decade earlier in Nigerian women and was usually advanced at presentation and of aggressive histological type. Of the breast carcinomas, 4.3 per cent were associated with pregnancy.