Clinicohistopathological evaluation of breast masses and profile of breast diseases in Eritrea: a case of poor concordance between clinical and histological diagnos

Abstract

Background: Profile of breast disease varies with sex and age with predominance of cancers in older females. For patients presenting with breast masses, triple assessment using clinical, radiological and histological methods is desirable, with the latter considered to be the golden standard. Little information is available on the features of breast diseases in Eritrea.
Objective of the study: To investigate the profiles of breast diseases, and to determine the concordance between clinical and histological diagnoses so as to develop evidence based policies and cost effective management guidelines for the disease
Methods: This was a retrospective study of 89 patients presenting with clinical diagnosis of breast masses from 1st January 2006 to 31st December 2006. Biopsies taken from the patients were histologically examined and reported by one pathologist from the National Health Laboratory of the Ministry of Health, Asmara, Eritrea.
Results: The majority of cases were women (96.6%). The age at presentation ranged from 16 to 86 years. About half of the sample 43 (49.4%) had clinical diagnosis of breast cancer. The study found that, the concordance rates between clinical diagnosis and histological diagnosis were lower for carcinoma and benign lesions 46.5% and 80% respectively. Three quarters of the fibroadenomas were found in women younger than 36 years.
Conclusion: Benign breast lesions and carcinomas were common in females, with the former being more prevalent in women less than 36 years and the latter in women older than 50 years of age respectively, which is consistent with other reports. Because of relatively low concordance between clinical and histological diagnosis, findings from this report recommend that all patients with breast masses undergo biopsy and histological examination.