Research Article: Mammographic classification of breast lesions amongst women in Enugu, South East Nigeria

Date Published: December , 2017

Publisher: Makerere Medical School

Author(s): Uchechukwu I Nwadike, Charles U Eze, Kelvin Agwuna, Chibuzo Mouka.


The study was to classify lesions identified on mammograms using Breast Imaging Reporting and Data System (BIRADS) grading method. This was in view of ascertaining the rate of occurrence of breast malignancy of the studied population.

A retrospective cohort study of 416 mammographic reports of women was undertaken. The reports were written by consultant radiologists of 10 years’ experience and above. The reports were evaluated and characterised using Breast Imaging Reporting and Data system (BIRADS). Demographic data of patients were sourced from the request cards. The data was entered into a proforma and analysed using SPSS version 17. All request cards with incomplete data were excluded from the study.

Using the BI-RADS Classification, the mammographic reports shows that 29.57% of the lesions were benign, and 4.57% were suspicious and biopsy recommended, while 3.60% were highly suggestive of malignancy. The right breast was predominantly affected with 42.7% of the patients (P<0.05). Classification of breast lesion using BI-RADS grading system is a veritable tool in the diagnosis of the breast lesion. The present study shows that 3.6% of the population has a high index of malignancy.

Partial Text

Mammography is the use of low energy X-ray beam to examine the breast for abnormalities1. Mammography investigation is the most sensitive mode of breast imaging2. It has the ability to detect micro-calcification which cannot be delineated by clinical examination or other imaging modalities3.

A retrospective cohort study of 416 patients who were randomly selected using simple randomization technique from patients who presented for mammography from January 2010 to December 2013 was done. The study setting was the mammography section of the department of radiation medicine, University of Nigeria Teaching Hospital (UNTH), Ituku Ozalla, Enugu. The hospital is a tertiary health facility which is a centre of excellence and serves as a referral centre for special radiological examinations such as mammography. It is a catchment area for people living in the South-East geopolitical zone of Nigeria and beyond. Data reviewed were from request forms, mammographic reports, and mammographic films of patients. The data involved were the age, sex, indication for mammography, side of the breast, and mammographic findings. Request cards without relevant data such as age, clinical indication and side of breast were excluded from the study. The mammographic equipment used to obtain the images was Alpha RT manufactured by GE Hungary ZRT in the year 2009, model MGF — 101.

Four hundred and sixteen patients who underwent mammographic examination were reviewed.

Mammography of four hundred and sixteen women was undertaken in this study. The study involved women between the age brackets of 15 years and above. The majority of women who were examined within the period of the study fell in within the age bracket of 41–50 years. This finding is in keeping with previous studies carried out in USA and Britain2,10. It is worthy to note that this age bracket is very vulnerable to cancer of the breast as noted in the previous studies10. Women with palpable masses and breast skin changes were 2.4% while it was 5% in a similar study by Wallak et al, while the study by Naku Ghartey et al had a value of 0.76%19,21. The difference in the statistics may be due to the population used in the study. The mean age for this present study was 44n.4 + 12.1 years and varied with the findings of other studies done in USA and Britain where the mean age are 61 and 50 years respectively2,10.




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