SCREENING FOR PREGNANCY ASSOCIATED BREAST CANCER AT NATIONAL HOSPITAL, ABUJA

Dr. Mahmoud A. R.*, Dr. Amin S.M., Dr. Usman Gwaram A.

ABSTRACT

Breast cancer occurring during pregnancy presents a challenging clinical situation since the welfare of both the mother and the fetus must be taken into consideration in any treatment plan. It presents some difficulty in detection because of hormone-influenced tissue engorgement and the tendency to limit attention to the pregnancy itself. The need for early detection therefore is of paramount importance in order to prevent increased morbidity and mortality. Clinical assessment in pregnancy which entails breast and axillary examination might result in low detection rates because of changes in the breast during pregnancy and this may necessitate complimentary breast ultrasound scan for complete evaluation. A longitudinal comparative study involving antenatal clinic attendees at the National Hospital, Abuja was carried out between May 15, 2018 to February 22, 2019. A total of sixty four pregnant women participated in the study group. Sixty two (97%) of patients were aware of breast cancer. Three breast masses (4.7%) (two solid and one cystic) were detected in the antenatal period and two solid masses (3.1%) during post natal period. All solid masses detected in both ante natal and postnatal periods were detected by both clinical breast examination and breast ultrasound scan while the cystic mass was detected by breast ultrasound during the antenatal period only. Although more masses were detected with breast ultrasound scan than by clinical breast examination, there was no statistically significant difference between them, 3 versus 2; P=0.604. The histology report of the lesions showed fibroadenoma in all cases with masses, no breast malignancy was detected. We conclude that with increasing rates of breast cancer and late ages of childbearing, we will likely be faced with more cases of pregnancy associated breast cancer. Therefore, awareness and screening of breast cancer in pregnancy is of paramount importance so as to avoid late detection with its associated morbidity and mortality.

Keywords: Gestational breast cancer, breast cancer, Nigeria.