The role of mammography as a diagnostic aid in diseases of the breast at the Aga Khan Hospital, Nairobi
A retrospective and prospective study was carried out on 1,744 consecutive patients mammographed at the Aga Khan Hospital, Nairobi, between January 1981 and June 1987. All patienta were interviewed with the intention of obtaining information regarding breast cancer risk-related parameters - which were subsequentiy analysed. 75% of the patients were from within Nairobi and the remaining from rest of Kenya and neighbouring countries. Mammographically 4% of patients were found to have breast cancer, 57% had begnin breast disease and 39% were found to have detectable breast lesion. Histologically proven breast cancer was found in 60 patients with peak age incidence of 31-40 years and 50-60 years. Although all ethnic groups were almost equally represented in the study sample, 49% of patients with breast cancer were Asian settlers of Indian origin. Approximately 60% of breast lesions were located in the upper outer quadrant of the breast, and a larger percentage of patients with breast cancer had a positive family history as compared to the rest - suggesting hereditary implications. The radiography was found to be good and mammograms of good diagnostic quality. Some recommendations are made with regard to technique and improvements to the senograph itself. Overall, the mammographic accuracy of breast cancer detection was as follows:- Sensitivity 95%, Specificity 99%, Positive predictive value 92%, Negative predictive value 99%.