The prevalence and clinico-pathological features of benign proliferative breast diseases among female patients at Mulago Hospital: across-sectional study

Abstract

Background: Although the increasing incidence of breast cancer in Uganda has been well-documented, the possibility that benign proliferative breast disease (BPBD) among Ugandan women is increasing has not been determined. Benign breast diseases are common globally accounting for approximately 90% of the clinical presentations related to the breast. In Mulago Hospital Breast Clinic benign breast diseases accounted for 79% of the breast diseases among the women who presented there. It has been found that women with atypical benign proliferative breast lesions have risk of developing breast cancer. Objectives: To determine the prevalence and clinicopathological features of benign proliferative breast diseases among women with benign breast lumps. Method: A cross-sectional descriptive study conducted at Mulago Hospital Breast Clinic between January 2012 and June 2012; 208 women aged 12 years and above with palpable breast lumps were screened and 195 of them were enrolled into the study. Fine needle aspiration biopsies were taken for cytological examination. Results: The prevalence of BPBD was 17.95%. The prevalence of BPBL with and without atypia was 5.64% and 12.31% respectively. The proportion of the BPBD with atypical proliferation was 31.0%. The mean age and body mass index were 28.4 years and 23.26 respectively. Mean breast lumps diameter was 3.1cm. Age was associated with BPBD (p=0.008). Women with no history of hormonal contraceptives use were more likely to have BPBD compared to contraceptives users (p=0.1104). Fibroadenoma was the commonest benign breast lumps accounting for 56.92% (111 patients). This was followed by fibrocystic change 20.51% (40); epidermoid cyst 5.64% (11), fat necrosis 4.62% (9); lactating adenoma 3.59% (7); tuberculosis of the breast 2.05% (4) and others 6.67% (13). Conclusion: BPBD are common, mostly fibrocystic and found mainly among premenopausal women. The lesions with atypia were significant among perimenopausal age groups. Guidelines for follow up of atypical lesions should be developed.