ABSTRACT
OBJECTIVE: To describe the clinicopathologic profile of breast disease in Jamaica. METHODS: The Jamaican Breast Disease Study is an ongoing prospective, multidisciplinary investigation of breast disease at the University Hospital of the West Indies (UHWI). The initial phase was a prevalence survey comprising all consenting patients referred to the Surgical Outpatient Department (SOPD) UHWI, for breast disease. Demographic, clinical, radiologic and pathologic information were recorded for each patient and the data for the first three years (2000-2002) were analyzed. RESULTS: A total of 1189 patients was enrolled for the study period (28.8% of all new SOPD patients). The age range was10 to 93 years (mean/SD = 36.5 +/- 16.4 years) with a female : male ratio of 14:1. Most patients (67.8%) presented with a palpable lump and the clinical diagnosis was benign in the majority (70.4%) of patients. Fibroadenoma was the most common benign histologic result (39.4% of all biopsies) followed by non-proliferative (fibrocystic) disease (19.3% of all biopsies). Proliferative disease without atypia, complex fibroadenoma and atypical ductal hyperplasia accounted for 6.9%, 2.6% and 0.4% of biopsies respectively. Overall, 23.4% of biopsies showed malignant histology (10.8% patients); invasive ductal carcinoma accounted for the majority of these cases (69.5%). CONCLUSIONS: The majority of patients with breast disease in Jamaica are young women with clinically benign disease. There was a low prevalence of clinically significant premalignant disease. This is the first study to prospectively describe the clinicopathologic features of breast disease in Jamaica and supports the need for advocating breast cancer screening to facilitate detection of significant premalignant disease and early stages of breast cancer.
OBJETIVO: Describir el perfil clínico-patológico de la enfermedad de mamas en Jamaica. MÉTODOS: El "Estudio jamaicano de la enfermedad de mamas" - que continua realizándose en la actualidad en el Hospital Universitario de West Indies (HUWI) - consiste en una investigación prospectiva y multidisciplinaria de la enfermedad de mamas. La fase inicial fue un estudio de prevalencia que abarcó a todos los pacientes que dieron su consentimiento, y que fueron remitidos al Departamento de Cirugía Ambulatoria (DCA) de HUWI a causa de la enfermedad de mamas. Se registró información demográfica, clínica, radiológica y patológica de cada paciente, así como los datos referidos a los primeros tres años (2000-2002). RESULTADOS: Un total de 1189 pacientes fueron captados para el periodo de estudio (28.8% de todos los pacientes nuevos del DCA). El rango de edad fue de 10 a 93 años (media/SD = 36.5 + / - 16.4 años) con una proporción hembra:varón de 14:1. La mayoría de los pacientes (67.8%) presentó un nódulo palpable y el diagnóstico clínico fue benigno en la mayoría (70.4%) de los pacientes. El fibroadenoma fue el resultado histológico benigno más común (39.4% de todas las biopsias) seguido por la enfermedad (fibrocística) no proliferativa (19.3% de todas las biopsias). La enfermedad proliferativa sin atipia, el fibroadenoma complejo y la hiperplasia ductal atípica representaron el 6.9%, 2.6% y 0.4% de las biopsias respectivamente. En general, el 23.4% de las biopsias mostraron histología maligna (10.8% de los pacientes); el carcinoma ductal invasivo representó la mayoría de estos casos (69.5%). CONCLUSIONES: La mayor parte de los pacientes con la enfermedad de mamas en Jamaica son mujeres jóvenes con enfermedades clínicamente benignas. Hubo una baja prevalencia de enfermedades premalignas clínicamente significativas. Este es el primer estudio dirigido a describir prospectivamente las características clínico-patológicas de la enfermedad de mamas en Jamaica, y respalda la necesidad de abogar por el pesquisaje del cáncer de mamas, a fin de facilitar la detección de enfermedades premalignas significativas y las fases tempranas del cáncer de mamas.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Breast Neoplasms/pathology , Fibroadenoma/pathology , Fibrocystic Breast Disease/pathology , Age Distribution , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Fibroadenoma/diagnosis , Fibroadenoma/epidemiology , Fibrocystic Breast Disease/diagnosis , Fibrocystic Breast Disease/epidemiology , Hospitals, University/statistics & numerical data , Jamaica/epidemiology , Prevalence , Prospective Studies , Sex DistributionABSTRACT
A retrospective analysis of the spectrum and relative frequency of salivary gland lesions diagnosed in the Department of Pathology, University of the West Indies, Kingston, Jamaica, between 1965 and 1994, is reported. Four hundred and sixty-four salivary gland biopsies were received. Of these 99 (21.3) were non-neoplastic and the remaining 365 (78.7) were neoplasms: 261 (71.5) were benign and 104 (28.5) malignant. Benign mixed tumour (BMT)/pleomorphic adenoma (PA) was the most common neoplasm (63.3) while mucoepidermoid carcinoma (MEC) was the most common malignant neoplasm (9.6), followed by adenoid cystic carcinoma (ACC) (7.4). The increased frequency of MEC over ACC is at variance with other reported series but the preponderance of pleomorphic adenoma is consistent. In the major salivary glands, benign neoplasms predominate at a ratio of 3:1, while a higher proportion of minor salivary gland neoplasms was malignant, ratio 1.2:1 (p = 0.003). These data represent the first attempt to document the spectrum of disease related to oral and maxillofacial pathology in Jamaica.