An audit of breast lumps detected during cancer screening: A report from Southwest Nigeria

Background: In low-Human Development Index countries, population-based screening programs for breast cancer are virtually nonexistent, but there are occasional screening programs organized by nongovernmental organizations in these countries. This study aims to describe the clinical and histopathological characteristics and the prevalence of breast diseases detected by clinical breast examination (CBE) in a cohort of women who participated in a community-based breast screening program. Methodology: This is a retrospective cross-sectional study of women who were referred for assessment in our Breast Clinic following CBE during a breast cancer screening program. Palpable lesions were subjected to biopsy and histopathological examinations. Results: Of the 2450 women screened, 102 had breast biopsy. Twenty-one were malignant (20.6%) and 79 were benign (77.5%). The mean age for benign breast disease was 32 ± 14 years, whereas that for women with malignant breast lesions was 57 ± 11 years (P < 0.001). Sixty-three women (61.8%) were married, 59 (57.8%) had tertiary education, and 27 (26.5%) were petty traders. The mean lump size was 3.8 ± 3.9 cm for benign lumps and 6.2 ± 4.2 cm for malignant lumps (P = 0.014). Histopathological examination revealed that 20.6% of the lumps were malignant, 50% were benign neoplasm (fibroadenoma,) 17.6% were fibrocystic change and related conditions (fibroadenosis), 5.9% were sclerosing lesions, 2% were inflammatory lesions, 2% were benign proliferative breast disease, and 2% were inadequate sample. Two of the 12 breast lumps (16.6%) were detected for the first time at screening, of which two were malignant. This constitutes 1.9% (2/102) of all the lumps biopsied and 0.081% of all the women who had CBE. Conclusion: This study has demonstrated that CBE as a tool for early detection of breast cancer should be encouraged and applied. It confirms that fibroadenoma is the most common cause of clinically obvious breast lumps.