Conference abstract

A comparative analysis of clinical breast examination and mammography screening among women in a tertiary hospital, Ekiti State, Nigeria, 2016

Pan African Medical Journal - Conference Proceedings. 2018:8(28).28 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.28.610

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Keywords: Mammography, breast cancer, specificity, sensitivity
Opening ceremony

A comparative analysis of clinical breast examination and mammography screening among women in a tertiary hospital, Ekiti State, Nigeria, 2016

Adebayo Fashola1,2,&, Segun Agboola2, Olabode Shabi2, Olufunso Aduayi3, Patrick Nguku1

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Federal Teaching Hospital, Ido Ekiti, Nigeria, 3Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria

&Corresponding author
Adebayo Fashola, Department of Family Medicine, Federal Teaching Hospital, Ido Ekiti State, Nigeria

Abstract

Introduction: breast cancer is the most common cause of cancer death among women in the world with one million new cases diagnosed worldwide annually. In Nigeria, late presentation is common due to poor screening practices. We conducted this study to determine mammography awareness of the study population, prevalence of breast cancer by clinical breast examination (CBE) and mammography; and the accuracy of CBE compared with mammography.

Methods: a cross-sectional study of 67 women aged 40 - 70 years attending family medicine department, recruited by systematic random sampling between March - June 2016 and interviewed about their screening practices and mammography awareness. Thereafter a specific physician carried out clinical breast examination (CBE) on the women using the American Cancer Society 2004 guideline. The patients had digital mammography done, interpreted by a radiologist and data analyzed using Epi Info 7. Univariate and bivariate analysis done, both sensitivity and specificity of CBE were determined using mammography as gold standard.

Results: the mean age was 48.0 years, with a standard deviation of 9.9 years. Of all the respondents, 64 (95.5%) were married and 2 (3.0%) widowed. Regarding education, 70.2% had completed at least tertiary level while 7.6% were uneducated. Thirty-three 33 (49.3%) regularly practiced Breast Self-e\Examination while 16 (23.9%) had previous CBE. Altogether, 53 (79.1%) were aware of mammography while 6 (9.0%) had done it. The prevalence of breast lump detection by CBE and mammography was 10.5% and 21.4% respectively. Malignancy was suspected in 3 (4.5%) of the patients by CBE and benign findings in 6 (9.0%) while mammography identified 4 (6.0%) and 16 (23.9%) as malignant and benign respectively. The sensitivity of CBE was 15.0%, specificity 82.4% and positive predictive value 33.3%.

Conclusion: there is a gap between awareness and practice of mammography among the study population. While CBE is highly specific, its sensitivity is low. It is recommended that women 40 years and above be advised to have regular mammography screenings.