Date of Award
5-2019
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Sudhir Vinayak
Second Supervisor/Advisor
Rose Ndumia
Department
Imaging and Diagnostic Radiology (East Africa)
Abstract
Introduction: The most common cancer affecting women in Kenya is breast cancer with an incidence of 40.3 per 100 000 at risk population in 2018(1) while Nairobi has a higher incidence of (ASR 51.7 per 100,000) (2).This constitutes a major public health problem so early diagnosis plays a major role in mortality reduction and improving prognosis of breast cancer(3). Mammography is the most sensitive technique for detecting non palpable lesions. Over the decades it has been shown that in the USA there has been significant reduction in breast cancer mortality by 40% due to screening mammogram (4). On mammography the initial features of breast cancer that is seen is suspicious calcifications, which plays a major role in diagnosing breast cancer. Calcifications represent calcium deposits within breast tissue. Nearly 30% of patients with invasive breast cancer have suspicious calcifications detected on mammogram. However, the prevalence of suspicious calcifications in the African breast cancer is not documented
Objectives: To determine the prevalence of suspicious mammographic calcifications in newly diagnosed breast cancer patients at the Aga Khan University Hospital, Nairobi.
Study design: Cross sectional study with data gathered retrospectively.
Methods: All newly diagnosed breast cancer patients over a 3-year period starting from November 2016 were identified. Their mammographic images at the time of diagnosis were then reviewed for presence of suspicious calcifications. The corresponding histopathological data of the breast cancer were also obtained and relevant clinical information from the patient files.
Results: The overall prevalence of suspicious mammographic calcification was 40 % in the 139 patients recruited in this study. Regarding morphology of calcification 24 patients (44%) had coarse heterogeneous and (29%) had fine pleomorphic while in terms of distribution 23 patients (42%) had grouped and 24 patients (44%) had segmental distribution. We found10 patients (18%) had calcifications alone with no associated abnormality while 82% calcifications were associated with a mass. Nearly all the DCIS patients 10 out of 11 presented with suspicious calcifications. Conclusion and recommendation: This high prevalence of suspicious mammographic calcifications (40%) in newly diagnosed breast cancer patients underpins the importance of screening mammography in early detection of breast cancer and rolling this out in our population. Mammogram is necessary in order to identify presence of suspicious mammographic calcifications that may go beyond a mass and hence require more extensive surgery. Larger study to investigate the association between mammographic calcification and the clinicopathological characteristics of breast tumors is recommended
Recommended Citation
Omar, M. A. (2019). Prevalence of suspicious mammographic calcification in newly diagnosed breast cancer patients at the Aga Khan University Hospital, Nairobi. (Unpublished master's dissertation). Aga Khan University, East Africa.