Breast diseases histologically diagnosed at a tertiary facility in Uganda (2005–2014)

Abstract

BackgroundThe prevalence and distribution of histologically diagnosed breast disease are not well documented in low income countries, Uganda inclusive. Although the greater majority of breast lesions globally are benign, breast cancer is the most frequently diagnosed cancer all over the world. We aimed at documenting the prevalence of different breast diseases histologically diagnosed at the histopathology laboratory of the Department of Pathology of the Makerere University College of Health Sciences (MakCHS Lab) over a decade (2005–2014). We also describe the demographic characteristics of the patients in Uganda diagnosed with breast disease at the MakCHS Lab during the same period.MethodsThis was a 10 year retrospective study of histologically diagnosed breast disease between 2005 and 2014 inclusive at the MakCHS Lab. We extracted information from hard copies of all 2510 histopathology reports retrieved from archives of the Department of Pathology at the MakCHS Lab. 640 records that were either damaged beyond recognition of key details, were duplicated, were implausible or had no conclusive diagnosis made were excluded. Information to be analyzed was then entered into Epidata (version 3.1) on a password protected laptop. Data analysis was done using SPSS software (v16 for Windows × 64).ResultsFrom the 1870 patients’ records eventually analyzed, breast disease was most diagnosed in female patients (97.1%). The overall mean age for breast disease diagnosis was 33 years (S.D ± 16.46) and median age 26 years (IQR: 20–43). Fibroadenoma (40.1%) was the most diagnosed breast disease overall. We noticed steadily increasing frequency of diagnosis of cancerous breast diseases over the last half of the study period. Invasive ductal carcinoma was the most diagnosed breast cancer (326 cases, 55.6%). A high female to male breast cancer ratio of 48:1 was observed. The highest regional breast cancer proportion was from the Western region of the Country.ConclusionsThere is need for more research into the picture of breast disease in the country, covering various demographic characteristics of the country’s population for all regions and informing about its incidence rates and prevalence and also the breast cancer risk estimate for benign breast disease.

Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review

“…Three studies were from Malawi, where one was a retrospective review of the registry ( 53 ) and two were retrospective cohort studies ( 66 , 68 ). There were three studies from Uganda, two were retrospective record reviews of pathology reports ( 90 , 95 ) and one was a retrospective record review of registry ( 59 ). Two studies were from South Africa, one retrospective record review ( 26 ) and a cross-sectional study of Demographic and Health Survey (DHS) data ( 125 ).…”

The spectrum of male breast disease at Charlotte Maxeke Johannesburg Academic Hospital - a 3-year retrospective review

“…Gynaecomastia was the most common diagnosis, followed by fibrocystic breast disease and infiltrating ductal carcinoma. 7 By comparison, the current study identified a total of 37 males with histopathologically confirmed MBD, diagnosed with nine different pathologies, over a period of three years: invasive carcinoma was the most common histopathological diagnosis, followed by gynaecomastia. This suggests that CMJAH may diagnose more men with MBD histopathologically and see a wider variety of pathology than identified in Uganda.…”

“…The most common diagnoses were proportionately different in each study. While the CMJAH Breast Imaging Department follows a strict protocol regarding which patients warrant biopsies based on their BI-RADS grading, it is not evident if the same protocol was followed in the study done by Ssemmanda et al 7 This could explain the difference between the most common diagnoses identified by each study. In the Ugandan study it is possible that a greater number of males underwent biopsies for conditions which would be diagnosed radiologically at the CMJAH Breast Imaging Unit.…”

“…In Uganda, a 10-year retrospective review of histopathology reports found gynaecomastia (44%), fibrocystic breast disease (22%) and infiltrating ductal carcinoma (17%) to be the three most common diagnoses among male patients. 7 Furthermore, in a Turkish study which looked at all MBD diagnosed by triple assessment, gynaecomastia was the most common diagnosis (87%), followed by primary breast carcinoma (6%) and fat necrosis (2%). 8 Despite only accounting for less than 1% of all male cancers and less than 1% of all breast cancers, 9,10 male breast cancer (MBC) constitutes the largest proportion of the literature pertaining to MBD.…”

“…8 Despite only accounting for less than 1% of all male cancers and less than 1% of all breast cancers, 9,10 male breast cancer (MBC) constitutes the largest proportion of the literature pertaining to MBD. The reported incidence of MBC in sub-Saharan Africa is increasing, 7,9,11 but as it is so rare the diagnosis may initially not be considered and, for this reason, a thorough understanding of all MBD, benign and malignant, is essential for timely and accurate diagnosis. 10 One meta-analysis reviewing data across 27 African countries, revealed that the male-to-female ratio of breast cancer in Africa was 1:24, higher than in other parts of the world, 9 such as America with an overall male-to-female…”