Positive malignant margins in clinically diagnosed and excised be-nign breast lumps: a five year retrospective study at the Korle-Bu teaching hospital, Ghana

Abstract

This study was aimed at utilizing retrospective descriptive data to evaluate the percentage of clinically benign breast lumps that turned out to be histologically malignant and the prevalence of positive tumour margins among the malignant cases. A total of 2,917 registered cases of excised breast lump at the Department of Pathology spanning January 2005 to December 2009 were reviewed to evaluate the presence of malignancy and positive margins. Three hundred and twenty-two (11.0%) of the excised breast lumps were found to contain malignant tumours, out of which 142(44.1%) had positive tumour margins. Size of primary tumour (p=0.001) and histologic subtype (p=0.002) showed significant positive and negative associations in relation to positive tumour margins respectively. No significant association was observed between the positive tumour margins and histologic grade (p=0.363).The study showed that clinically benign breast lumps could be malignant and not completely excised, therefore increasing the risk of local recurrence. Thus, it is recommended that all women with breast lumps have the triad (diagnostic workup) of clinical and radiological assessment, followed with histological studies.

Positive Tumor Margins in Wide Local Excision of Breast Cancer: A 10-Year Retrospective Study

“…In our study, the mean age of women with positive margins was 53.4 years, with a modal age group of 40-49 years. This age group is similar to the findings in previous studies in Ghana [9,8,11]. Young age has generally been found to be associated with an increased risk of local recurrence after breast conserving surgery [21,32,35].…”

“…Our rate of 21.1% is in accord with these studies. However, this value is lower than Der et al studies of positive malignant margins in clinically diagnosed and excised benign breast lumps, in which they found that 322 (11.0%) out of 2,917 clinically benign lumps during the study period were malignant and that 142 (44.1%) had positive margins [9]. The high rate of positive margin in that study was because the excisions were not wide local excisions.…”

“…Positive margins are a major risk factor for the development of local recurrence [2,5,7,18,19], and systemic disease [15,16]. Breast cancer is said to be commoner in young Ghanaian women [9,8,11]. Younger age at diagnosis is found to be a risk factor for positive margins [21,32,35].…”

“…To the best of our knowledge there is no study that has evaluated the safety of lumpectomy as a surgical option for the treatment of early breast cancer. However, Der et al (2013) in their study "Positive malignant margins in clinically diagnosed and excised benign breast lumps" found that 321 (11.0%) out of 2,917 excised breast lumps were malignant and that 142 (44.0%) had positive tumor margins [9]. The aim of this study is to use retrospective histopathological descriptive study to evaluate the prevalence of positive tumor margins among wide local excision (lumpectomy) specimens of Ghanaian women with early breast cancer treated by this method and to suggest some recommendations.…”

Epidemicity of Thyroid Gland Disorders Among Ranya Town Dwellers: A Hospital-Based Survey

“…The greatest male and female cases were having sub-clinical hyperthyroidism and they were in older age groups in the present study. The prevalence of thyroid disorders has been found to increase linearly with age and virtually all thyroid diseases are common in women (Der et al, 2013). Other researchers showed that in females, thyroid disorders were most common as compared to males (Bustany, 2011, GovindanKutty et al, 2013, Al-Msari et al, 2014, Shahrani et al, 2016 and thyroid disorders would be increased with the advancing age (Mariotti et al, 1995).…”