Magnetic resonance imaging of fibroadenoma-like lesions and correlation with Breast Imaging-Reporting and Data System and Kaiser scoring system

Background: Multiple breast lesions resembling fibroadenomas are a common imaging finding in patients presenting to the mammography unit at Dr George Mukhari Academic Hospital in the North-West district of Tshwane, South Africa. Patients often present with multiple lesions, up to 20 lesions per breast. These lesions often have atypical features on ultrasound and/or a clinical history of growth is commonly given. Phyllodes tumours may be indistinguishable from fibroadenomas and breast cancers may on occasion present with benign features, which can lead to misdiagnosis. Breast magnetic resonance imaging (bMRI) evaluation of lesions resembling fibroadenomas may improve accurate assessment and identification of lesions requiring biopsy. Objectives: To assess the reliability of bMRI to characterise lesions resembling fibroadenomas on ultrasound, using the Breast Imaging-Reporting and Data System (BI-RADS) and Kaiser scoring systems with histopathological correlation. Method: A quantitative, prospective, investigative study was performed with a sample size of 100 breast lesions among a total of 35 patients at Dr George Mukhari Academic Hospital. Patients were recruited after a breast ultrasound investigation revealed lesions resembling fibroadenomas, but with an indication for ultrasound-guided biopsy, for example, very large size, atypical features on ultrasound or a history of recent growth. The bMRI was performed prior to the ultrasound-guided breast biopsies. Three investigators independently evaluated the bMRI and applied BI-RADS descriptors to each lesion. The Kaiser score was then calculated for each lesion. Statistics were calculated using Pearson's and Spearman's coefficients for inter-reader variability, kappa scores for BI-RADS and Kaiser score correlation with histology. Results: Evaluation with bMRI, BI-RADS and the Kaiser scoring system showed statistically significant correlation with each other and with histopathology results for each lesion. There was statistically significant agreement among the investigators regarding the interpretation of the lesions and allocation of appropriate BI-RADS scores. Conclusion: Multiple lesions resembling fibroadenomas can be evaluated with bMRI when multiple breast biopsies would not be feasible. With a good imaging protocol and technique, adequate interpretation skills by the radiologist and the use of the Kaiser scoring system, an accurate diagnosis can be achieved

Fine needle aspiration cytology of breast lumps with histopathologic correlation in Owo, Ondo State, Nigeria: a five-year review

Objective: To determine the histopathologic correlation of fine needle aspiration cytology FNAC of breast masses seen in the department of histopathology of the Federal Medical Center Owo, Southwestern Nigeria.Design: This is a 5-year retrospective study of breast lumps seen at Department of Histopathology, Federal Medical Centre Owo, a tertiary health care facility in Southwestern Nigeria between January 1 2010 and December 31 2014.Participants: All patients who had Fine Needle Aspiration Cytology of Breast lumps with subsequent histological confirmation over this period were included in the study.Results: In the five years under review (2010-2014), a total of 289 FNAC of breast lumps were done. The aspirates were obtained from 275 (95.2%) females and 14 (4.8%) males. There were 161 cases of FNAC with corresponding tissue for histological correlation giving a biopsy rate of 55.7%. The sensitivity of FNAC in determining the final histologic diagnosis was found to be 99.4% while the specificity was 100%. FNAC was able to determine final histologic diagnosis conclusively in 86.3% of cases.Conclusion: We therefore concluded that FNAC is a reliable diagnostic tool of breast lumps in our centre. Being a fast and cheap diagnostic tool as highlighted by previous studies, we advocate that clinicians should continue to embrace this diagnostic technique in the surgical management of breast lumps

Pubertal breast development in primary school girls in Sokoto, North-western Nigeria

Background. There is wide variation in normal pubertal timing among various populations. Objectives. To determine the mean age of pubertal stages of breast development and menarche, and the influence of nutrition and ethnicity on pubertal onset in primary school girls in Sokoto, North-Western Nigeria.Methods. A cross-sectional study using a multistage random sampling design was conducted on 994 primary school girls in grades 3 - 6. Weight and height measurements and Tanner breast staging were done. Body mass index (BMI) was calculated, and a BMI-for-age percentile was used to categorise nutritional status. There were four major ethnic groups. P≤0.05 was taken as showing statistical significance. Results. The participants' mean age was 10.23 years (standard deviation (SD) 1.70, range 6 - 15 years). Of the 994 girls, 628 (63.2%) were pre-pubertal, and 366 (36.8%) were pubertal. Of the latter, 158 (15.9%) were in breast stage 2, while 112 (11.3%), 70 (7.0%) and 26 (2.6%) were in breast stages 3, 4 and 5, respectively. The mean ages (SD; range) of pubertal onset and menarche were 10.50 (1.33; 8 - 13), and 12.67 (1.65; 11 - 15), years, respectively. The overnourished (overweight/obese) and Igbo ethnic group girls had early-normal pubertal onset (p=0.006 and p=0.001, respectively). Conclusion. The mean ages of Tanner breast stages 1 - 5 and menarcheal age of girls in Sokoto, North-Western Nigeria, were within the age ranges reported worldwide. Pubertal onset was influenced by nutrition

Métastases sternales d'un adénocarcinome mammaire chez l'homme

Le cancer du sein est considéré comme une maladie de la femme, une majorité (69%) de l'ensemble des décès par cancer du sein surviennent dans les pays en développement. Ce cancer peut aussi apparaître chez l'homme, mais pas beaucoup rapporter (moins de 1 % des cancers du sein). Nous rapportons une nouvelle observation de métastases sternales d'un cancer du sein chez un homme âgé de 66 ans et qui a consulté pour une ulcération trainante du sein gauche associée à des douleurs sternales insomniantes et invalidantes depuis 2012. Le diagnostic du cancer du sein a été confirmé par l'examen anatomo-pathologique et le type histologique est un carcinome canalaire infiltrant du sein grade II selon SBR. Le scanner a révélé une lyse sternale et une adénopathie axillaire homolatérale.Six mois après la chimiothérapie, il y'a eu une cicatrisation de l'ulcération

Pattern of Histopathological Diagnosis of Breast Lesions in Gombe; Nigeria

Background:Diseases of the breast are common and include problems; related to pregnancy and lactation; abscesses and other inflammatory conditions; nonneoplastic proliferative disorders and neoplasms. No known previous histopathological analysis has been done in our setting to classify breast lesions.The purpose of this study is to review all cases of breast diseases seen in the department over a six-year period and to determine the pattern of histological diagnosis of breast diseases in our setting.Methods: This was a hospital based retrospective study where our bench record books were used to identify all the breast lesions after which the Haematoxylin and Eosin stained slides and the request cards were retrieved. The slides were reviewed based on the diagnostic criteria by Juan Rosai. Results: A total of 291 breast lesions were seen in the department. One hundred and seventy three (59.5) of these were inflammatory; non-neoplastic proliferative and benign neoplastic disorders; while 118 (40.5) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7) cases. Of all the malignancies; invasive ductal carcinoma was the most frequent (68.6). Breast cancer was found most frequently in the 4th decade (32.2); followed by the 5th decade (24.6) of life. Conclusion: Female breast cancer was quite common in this study and most of our patients presented with advanced disease

Pattern of Histopathological Diagnosis of Breast Lesions in Gombe; Nigeria

Background:Diseases of the breast are common and include problems; related to pregnancy and lactation; abscesses and other inflammatory conditions; nonneoplastic proliferative disorders and neoplasms. No known previous histopathological analysis has been done in our setting to classify breast lesions.The purpose of this study is to review all cases of breast diseases seen in the department over a six-year period and to determine the pattern of histological diagnosis of breast diseases in our setting.Methods: This was a hospital based retrospective study where our bench record books were used to identify all the breast lesions after which the Haematoxylin and Eosin stained slides and the request cards were retrieved. The slides were reviewed based on the diagnostic criteria by Juan Rosai. Results: A total of 291 breast lesions were seen in the department. One hundred and seventy three (59.5) of these were inflammatory; non-neoplastic proliferative and benign neoplastic disorders; while 118 (40.5) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7) cases. Of all the malignancies; invasive ductal carcinoma was the most frequent (68.6). Breast cancer was found most frequently in the 4th decade (32.2); followed by the 5th decade (24.6) of life. Conclusion: Female breast cancer was quite common in this study and most of our patients presented with advanced disease

Benign Breast Masses in Nigeria

A 5-year retrospective review of all benign breast masses was carried out at the Baptist Medical Center; Eku; Delta State between January 1st 2001 and December 31st 2005. Benign breast masses made up 72.64of breast biopsies; 96.10were females; with age ranged between 13 and 66 years (mean 28.8years). Fibroadenoma was most common (68.83) and the sizes ranged from 1cm to 14cm with mean of 3.66cm. This study shows that benign breast masses are common in this environment and encourages self-breast examination and clinical breast examination

Bilan des cancers du sein diagnostiques a l'Institut Pasteur de Madagascar de 1995 a 2001

"Breast cancer diagnosed at the Pasteur Institute of Madagascar : outcomes from1995 to 2001"" : Breast cancer is a great problem of public health all over the world. In developed countries; breast cancer represents the most common cancer in females. Its incidence is also increasing in developing country. In Madagascar; no data is available to estimate the real incidence and prevalence rates of breast cancer. However; the data at the Institut Pasteur de Madagascar can confirm the extent of the problem even if it is not at a national scale. The authors report the results of a retrospective study from histological examination at the Laboratory of pathological anatomy of the IPM; during 7years. Among 2 337 cases of cancer; 16"

Caracteristiques des adenofibromes du sein a propos de 104 cas colliges dans le service de Gynecologie-Obstetrique du CHU de Treichville

"Un module ou une"" boule "" de sein suscite des inquietudes chez la femme; a savoir:-quelle est la nature de ce nodule-quelle attitude adopter vis-a-vis de ce nodule?Pour tenter de repondre a ces inquietudes et cerner les problemes qui decoulent; nous avons entrepris une etude prospective de 104 dossiers d'Adenofibrome de sein collige dans le service de gynecologie et d'obstetrique du CHU de Treichville.Nos investigations nous ont permis de rassembler les faits suivants :-Les donnees epidemiologique; clinique et paraclinique de l'affection retrouvee corroborent avec la revue de la litterature. La plus jeune patiente de notre serie a 13 ans.-L'apparition de l'adenofibrome a eu lieu avant Ia demarche dans trois cas.-Les difficultes de diagnostic avec les autres etats d'hypertrophie mammaire notamment les kystes et les tumeurs phyllodes sont soulignes.-L'anatomie-pathologie a permis de preciser le diagnostic dans 101 cas.-101 patientes ont beneficie de traitement chirurgical qui a consiste en une enucleation et exerese complete de la tumeur. Nous n'avons pas note de recidive."