Usefulness of mammography in the investigation of svmptomatic patients under 30 years of age at Kenvatta National Hospital

Abstract

A total of 131 patients under 30 years of age underwent mammographic examination during the period from January 1992 when the mammography unit at Kenyatta National Hospital started operating, to July 1995. Of these, 20 patients were referred from hospitals outside Kenyatta National Hospital and·were therefore excluded from the study. Of the 111 patients included in the study, 2 (1.8%) were males, both who had been referred for investigation of gynaecomastia, and the rest (98.2%) The commonest complaint that lead to mammographic investigation was lump (34.2%) followed by breast swelling (20.7%), breast pain (17.1%) and breast discharge (10%). The most frequent physical I sign was a palpable lump (46.9%) , followed by tenderness (15.3%) and breast discharge (13.5%). 12.6% of patients had normal physical examination findings. 58 patients (52.3%) had normal mammograms. Of the abnormal mammograms 2 (1.8%) were suggestive of carcinoma of the breast, and in 2 cases (1.8%), no mammographic diagnosis was made because the breast parenchyma was too dense. Of the 13 patients who were recommended for ultrasound following mammography, 4 showed a solid mass while the rest did not have the examination. 8 patients recommended for follow up mammography did not have the examination done and 1 patient recommended for ductography showed pooling of contrast in scar tissue. Of the 9 patients recommended for biOPSY, only 3 were done which showed fibrocystic mastopathy, fibroadenoma, and cystosarcoma phylloides.

30 patients (27%) had benign biOPSY findings, 2 (1.8%) were mal ignant, 3 (2.7%) were non di agntrs-tLc _and 1 (0.9%) was non specific (unusual cell combination). Biopsy results for the rest of the patients could cases of fibroadenoma was not be obtained. Only in 2 there correlation between mammograph ic and, hi stolog ically diagnosed. the two cases thought to have mammographically were not available. 90% to 95% of breast cancers BiOPSY findings for malignant disease are found themselves, examination, either accidentally but mammography is the cancer earlier(ll. The or by by the patients breast self detect breast only method that will value of mammography as an investigative method for young patients has, however, been doubted by some investigators(2,3) since these young patients have dense breast tissue which may obscure pathology in a mammogram, are less likely to develop breast cancer,and are at a higher risk of radiation induced carcinogenesis.