Risk Factors for Breast Malignancy among Women Presenting with Breast Masses in a Teaching Hospital in Lagos, Nigeria

Abstract

Background: Breast cancer is the commonest female malignancy globally with increasing prevalence in Nigeria. This study aimed at identifying factors associated with malignant breast masses among women with breast masses receiving care at the Lagos University Teaching Hospital (LUTH). Materials: This cross-sectional, descriptive study investigated 100 women with breast masses by history-taking, clinical breast examination and biopsy for histopathology assessment. Sociodemographic characteristics, family, social, gynecologic, and obstetric history were obtained, and features of breast mass on examination were documented and histology specimens were taken for assessment. The proportion of women with malignant breast masses by biopsy was calculated. Using binary logistic regression analysis, factors associated with malignant breast masses were identified. Significance level was set at p < 0.05. Results: The mean age of participants was 39.4±13.4 years. Most were married (63.0%), overweight (53.0%) and had tertiary level of education (58.0%). The right breast was affected in 56% of women, while most breast masses were oval (49.0%). History of breast pain, exclusive breast feeding and nipple retraction was reported in 76.0%, 35.0% and 17.0% respectively. Malignant breast masses were identified in 46.0% of women and associated factors included increasing age (OR=10.95 – 442.00; p<0.05), married women (OR=6.96; p: 0.001), obesity (OR= 16.20; p: 0.003). Clinical symptoms associated with malignant breast mass included history of previous breast mass (OR = 3.93; p: 0.028), breast pain (OR = 3.07; p: 0.023), nipple retraction (OR=7.44;0.003) and nipple discharge (OR = 10.24; 0.003). Conclusion: The study found that a high percentage of breast masses assessed by biopsy were malignant among the studied populace. Factors significantly associated with increased risk of malignant breast mass included increasing age, obesity, and marital status. We recommend lifestyle modification as well as adoption of primordial and primary prevention measures in tackling problems related with breast cancer among Nigerian women. This should also include the improvement of access to such services.