Diagnostic mammography in women in Ibadan: common indications and findings

Abstract

Introduction
The accuracy and sensitivity of mammographyhas beenestablished indeveloped countries making its use a significant success but there is limited knowledge about this imaging modality in low resource settings. This study aimed at demonstrating the common indications for diagnostic mammography in our environment and the associated findings.

Materials and Methods
This is a retrospective descriptive study of 520patients who presented for diagnostic mammography over a 5 year period(2008-2013) in the Radiology department of the University College Hospital, Ibadan, Nigeria. Data was extracted from departmental recordsof women who presented for diagnostic mammograms between the stipulated periods and from their mammographic reports. The mammographic findings wereclassified using the ACR BIRADS American College of Radiology Breast Imaging and reporting data System; and assignedto a final BIRADS category.Data was entered into SPSS version 20.0, edited and analysis carried out. Results are presented with frequency tables.

Results
A total of 520 women with age ranging between 40 to 69 years presented for diagnostic mammograms. The most common complaints were pain in318 (61.2%) and lumps in 164 (31.5%).The majority of women who complained of breast pain had normal mammograms 238(74.8%) however, lumps were found in 48(15.1%) women. Benign masses(final BI-RADS 2) accounted for 42(13.2%; while 6(1.9%)patientsdemonstrated malignant looking masses(final BI-RADS 4-5). Out of 164 (31.5%) women with complaintsofalump, 52 (31.7%) showed no abnormality while 90 women (54.9%) demonstrated masses on their mammograms.Fifty eight (35.4%)mammograms demonstrated benign masses (final BI-RADS 2) while malignant masses(final BIRADS4 and 5) were seen in 32 (19.5%). Asymmetric density was the other finding in women presenting with breast lumps in 22 (13.4%) women (BIRADS 0).Overall findings in 520 women with diagnostic mammograms revealed no abnormality in 314/520(60%) patients. One hundred and forty three(24%) patients had breast masses; 100/69.9% benign, 43/30.1%malignant. Calcifications 22(4.2%), asymmetric density 33(6.4%), dilated ducts 3(0.6%) and mondors disease 1(0.2%) accounted for the rest of the findings. Biopsy confirmed malignancy (invasive ductal carcinoma in 4women.

Conclusion
This study shows that breast pain and breast lumps were the most common indication for diagnostic mammogramsin the University College Hospital, Ibadan, and Southwestern Nigeria. However, the majority of mammograms were normal but benign breast lumps were common findings.