A longitudinal study of the prevalence and characteristics of breast disorders detected by clinical breast examination during pregnancy and six months postpartum in Ibadan, Southwestern Nigeria

Abstract

BackgroundBreast disorders cause great anxiety for women especially when they occur in pregnancy because breast cancer is the most common cause of cancer related deaths in women. Majority of the disorders are Benign Breast Diseases (BBD) with various degrees of associated breast cancer risks. With increasing breast cancer awareness in Nigeria, we sought to determine the prevalence and characteristics of breast disorders among a cohort of pregnant women.MethodsA longitudinal study of 1248 pregnant women recruited in their first trimester- till 26 weeks gestational age consecutively from selected antenatal clinics (ANCs), in Ibadan, Southwest Nigeria. A pretested interviewer- administered questionnaire was used to collect information at recruitment. Clinical Breast Examination (CBE) using MammaCare® technique was performed at recruitment and follow up visits at third trimester, six weeks postpartum and six months postpartum. Women with breast disorders were referred for Breast Ultrasound Scan (BUS) and those with Breast Imaging Reporting and Data System (BIRADS) ≥4 had ultrasound guided biopsy. Statistical analysis was performed using Stata version 14.ResultsMean age of participants was 29.7 ± 5.2 years and mean gestational age at recruitment was 20.4 ± 4.4 weeks. Seventy-two participants (5.8%) had a past history of BBD and 345 (27.6%) were primigravidae. Overall, breast disorder was detected among 223 (17.9%) participants and 149 (11.9%) had it detected at baseline. Findings from the CBE showed that 208 (69.6%) of 299 breast disorders signs found were palpable lumps or thickenings in the breast, 28 (9.4%) were persistent pain, and 63 (21.1%) were abscesses, infection and mastitis. Twenty out of 127 (15.7%) participants who had BUS performed were classified as BIRADS ≥3. Lesions found by BUS were reactive lymph nodes (42.5%), prominent ducts (27.1%), fibroadenoma (9.6%), breast cysts (3.8%) and fibrocystic changes (2.5%). No malignant pathology was found on ultrasound guided biopsy.ConclusionsBreast lump is a major breast disorder among pregnant women attending antenatal clinics in Ibadan. Routine clinical breast examination and follow up of pregnant women found with breast disorders could facilitate early detection of pregnancy associated breast cancer in low resource settings.

Exploring physiotherapists’ clinical definition and diagnosis of inflammatory conditions of the lactating breast in Australia: a mixed methods study

“…The definition of mastitis adopted by the Academy of Breastfeeding Medicine (ABM) is breast inflammation presenting with "a tender, hot, swollen, wedge-shaped area of breast associated with temperature of 38.5°C or greater, chills, flu-like aching, and systemic illness" [1](p.239), and is consistent with other definitions [2,3]. Mastitis affects up to 20% of lactating women worldwide [4][5][6][7][8][9][10][11] with the highest incidence occuring in the first 6 months postpartum [12]. Untreated, mastitis can substantially impact on the mother's health and daily functioning, potentially leading to the cessation of breastfeeding [1,5].…”

Characteristics of Breast Masses of Female Patients Referred for Diagnostic Breast Ultrasound from a Saudi Primary Health Care Setting

“…In line with this finding, Odedina et al (2018) reported that females with more than two pregnancies had lower odds for breast disorders than those with fewer pregnancies. 5 Increasing the number of deliveries is a known protective factor for breast cancer among females in general. 5 In our study, this protective factor was reported more frequently among younger females.…”

“… 5 Increasing the number of deliveries is a known protective factor for breast cancer among females in general. 5 In our study, this protective factor was reported more frequently among younger females. History of breastfeeding is another known protective factor for breast cancer.…”

“…It has seven main classes; these are designated as 0 to 6 represented levels of; needing further assessment, negative, benign, probably benign, suspicious, highly suspicious findings, and biopsy-proven malignancy, respectively. 5 , 6 The front line’s role in family medicine is crucial in the management process of breast diseases especially in detecting the highly suspicious lesions early.…”

The Experiences and Support Needs of Women With Gestational Breast Cancer in Singapore

“…Women's indifferences toward their breast lumps aligned with past literature, in which those lumps were thought to be normal physiologic changes from being pregnant. [14][15][16][17] A study by Sim and colleagues 18 revealed that Singaporean women had poor knowledge of the risk factors, screening, symptoms, and treatments of breast cancer. Therefore, healthcare workers should actively educate women on breast screening techniques, with reinforcements at various stages of pregnancy and postpartum to better facilitate women's initial encounters with GBC regardless of cultural context.…”