Management of breast lumps in Maiduguri, Nigeria

Background: Reported changes in the demography, modes of presentation and histological variants of tumors of the breast have been published in developed and some developing countries. Although benign lesions have persistently accounted for most breast tumors, the incidence of malignant breast lesion in young women in sub-Saharan Africa has been disturbingly high. We reviewed the demographics, pattern and management of breast lumps excised at University of Maiduguri Teaching Hospital (UMTH) over a 6 year period. Patients and Methods: A retrospective study of patients with breast lumps at UMTH was carried out between January 2005 and December 2010. Details of their bio-data, clinical, and histopathology details were analyzed using descriptive statistics. Results: A total of 913 patients, comprising 887 females (97.2%) and 26 males (2.8%) were reviewed. The mean age was 33.1 ± 14.6 years (range: 12-80 years) and the mean duration of symptoms was 8 ± 2.14 months (range: 2-23 months). 359 (39.3%) were malignant and 577 (63.2%) were benign. The mean ages of women and men with invasive carcinomas of the breast were 45.58 ± 13.22 and 49.75 ± 18.28 years, respectively. The mean age of women with benign breast disease was 28.4 ± 10.0 for fibrocystic disease and 21.8 ± 5.31 years for fibroadenoma. Mode of presentations included ulcers (8.7%), axillary lymph node enlargement (30.0%), nipple discharge (13.0%) and breast pain (21.7%). The most common histological diagnoses were carcinoma of the breast, N = 340 (37.2%), fibroadenoma, N = 276 (30.2%) and fibrocystic disease, N = 199 (21.8%). The least common pathology was tuberculosis of the breast, N = 6; (0.7%). Conclusion: Though benign diseases are still more common, a high percentage of breast lumps in Maiduguri are due to malignant disease and this is frequent in younger women.