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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., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: open excisional breast biopsy is a known modality for treatment of breast lumps especially in developing countries. Other sophisticated methods are available for management of breast lumps in more advanced nations. Our aim in this study was to review the outcome of open excision breast biopsies in our setting with a view to improving patient management., Methods: this study was conducted at the National Obstetric Fistula Centre, Abakaliki, South East Nigeria among women who had excision breast biopsy between January 2015 and December 2016. Data was analysed using Statistical Package for Social Sciences (SPSS), version 21., Results: a total of 107 case folders were reviewed in this study. The mean age of the women was 27 ± 10 years. Overlying breast incision was the preferred route in 78(72.9%), periareolar incision in 28(26.2%), and Gillard Thomas's method (infero-lateral submammary sulcus incision) used in one patient with bilateral multiple breast lumps (0.9%). The complications recorded in this study were haematoma in 3(2.8%), wound infection in 5(4.7%) and wound breakdown in 1(0.9%). Hypertrophic scar was found in 2(1.8%) patients at follow-up. Overall, most patients were satisfied with the aesthetic outcome of their surgery., Conclusion: open excision breast biopsy is a useful modality for management of breast diseases in our setting. Complication rates are minimal. Both overlying and periareolar breast incisions results in aesthetically satisfactory scar in our practice. Inferior-lateral sub mammary sulcus skin incision is useful when the lumps are multiple and located at different quadrants of the breast. Appropriate use of drain helps to reduce the incidence of haematoma., Competing Interests: The authors declare no competing interests.

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.

Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre., Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement., Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign., Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.

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: Human cystericosis is the infection caused by the larvae of pork tapeworm Taeniasolium. The infection commonly affects the muscle, the central nervous system and subcutaneous tissues. The involvement of the breast is unusual., Objective: To present a 54 years old postmenopausal woman, a petty trader and a Jehovah witness who presented with a painless lump in the right breast which was increasing in size. The mass was clinically diagnosed by the Surgeon who examined her as a case of right breast cancer and an excisional biopsy was done., Method: A review of the case note, autopsy findings including gross and microscopic examinations and literature was done., Results: A histopathological appraisal of biopsy revealed the presence of the typical cysticercus larva and a definitive diagnosis of right breast Cystericosis was made. The diagnosis of cysticercosis in unusual sites such as breast may be clinically difficult and this supports why all biopsies must be sent to the pathologists for definitive diagnosis., Conclusion: Human cystericosis of the breast is rare, nevertheless, this should be considered as a differential diagnosis for amass in the breast particularly in the tropics and developing countries. To the best of our knowledge, this is the first case from our centre.

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.

Aims and Objectives: (1) To define the spectrum of breast diseases in the children and adolescents in Eastern Nigeria. (2) To provide where possible, an international comparison of statistical variations of both benign and malignant lesions in these age groups., Materials and Methods: The Morbid Anatomy Department of the University of Nigeria Teaching Hospital (UNTH) Enugu is a referral center for over 30 million people. The laboratory receives around 2,000 surgical pathology specimens per year. Virtually all children and adolescents (4-19) years who complained of a breast mass had a biopsy, and results of all excised breast specimens from children and adolescent age groups from 4 to 19 years were included in the study. The case files of these patients were retrieved and reviewed to ascertain the size and duration of the breast lesions. The number of phyllodes tumors seen in the child and adolescent population was compared to those seen in the adult population at the same period. Two independent pathologists reviewed the slides, and their results compared., Results: A total of 1050 breast specimens were received in the department of morbid anatomy from all age groups, from January 1, 2000 to December 31, 2004, out of which 121 (11.5%) were breast specimens from the children and adolescent age groups. On the average most patients with benign breast lesions presented within 3-5 months of their symptoms, which usually was a palpable lump detected in all cases by either the child or the mother. Their sizes vary from 2-3 cm and only ten were multiple but they were all confined to one breast. Those with phyllodes presented typically within 3 months probably because of the faster rate of growth. Their sizes varied from 5-13 cm and they were all unilateral. Phyllodes tumor in this age group constitute 28.6% of all phyllodes seen in this period and were all benign. The mean age was approximately 11.5 years while the median age was 18 years. Three cases were malignant., Conclusion: Fibro adenoma, fibrocystic breast disease, and low grade phyllodes tumor were the most common breast lesions seen in our children and adolescent population. The three cases of malignancy observed included invasive intraductal carcinoma, a non-hodgkin lymphoma, and metastases involving the lymph nodes from an uncharacterized secondary malignancy. Phyllodes tumors were typically larger in size and tended to present earlier. Genetic characterization of such lesions is recommended for future studies as well as their relationship to lesions seen among other Africans in Diaspora.

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.

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.

Objectives: To establish the role of Tru-cut needle biopsy in the pre-operative diagnosis of breast lesions in a developing country., Design: Prospective cross sectional study., Subjects: 112 consecutive patients with palpable breast lesions who had both Tru-cut and excision biopsy as a pre-operative diagnostic procedure., Results: Four (3.6%) patients had specimens that were inadequate for histological diagnosis. Tru-cut biopsy diagnosed 42 of the remaining 108 as malignant and 66 as benign, but only 40 and 61 respectively were confirmed to be correctly so by excision biopsy. Tru-cut biopsy, therefore, achieved a sensitivity of 88.9% (95% CI 79.7 to 98.1) specificity of 96.8% (95% CI 92.5 to 100) and an over all diagnostic accuracy of 93.5% (95% CI 88.9 to 98.2). There was a false positive rate of 4.8%, a false negative rate of 7.6% and a positive predictive value of 95.2%. The pathologist was able to make a correct specific histological diagnosis in 76.2% of all the adequate Tru-cut samples., Conclusion: If Tru-cut biopsy is done instead of excision biopsy, it will sufficiently reduce waiting time and reduce cost (four fold). It is well tolerated by patients. We regard the procedure as a useful adjunct and indeed a practical option for accurate pre-operative diagnosis of palpable breast lesions.

This study is a 10 year review of the benign diseases of the breast in Ile-Ife, Nigeria. A total of 362 cases were found. Three hundred and forty (95%) of the diseases occurred in females while 18 (5%) occurred in males giving a female-male ratio of 19:1. Fibroadenoma was the commonest lesion followed by fibrocystic disease. They accounted for 59.1% and 16.5% of benign breast diseases respectively. Acute and acute-on-chronic mastitis constituted 7.2%. These three lesions made up over 82% of the cases. Gynaecomastia was the commonest benign male breast disease and accounted for 3.8% of all the cases of benign breast disease. Apart from the atypical hyperplasia form of fibrocystic disease, benign diseases of the breast are not major predisposing lesions to malignant breast diseases.

376 Nigerian women who presented with histologically proved breast tumour (256 benign and 120 malignant) were admitted to a study of mastalgia and breast tumour. A total of 67 patients, consisting of 57 (22.3%) of 256 benign disease patients and 10 (8.3%) of 120 malignant disease patient had pain, compared to 199 (77.7%) benign and 110 (91.7%) malignant disease patients who had no pain. Mastalgia was more often associated with benign tumour (57 out of 67 or 85%) than malignant neoplasm (15%). Adenosis was the leading cause of mastalgia (15 of 26 patients). Surgical extirpation of breast tumour achieved total pain relief in 85% of the patients, but adenosis patients were least likely to achieve total pain relief.

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.