Introducing Digital Mammography in a Resource Constrained Setting: Spectrum of Imaging Findings and Diagnostic Value in Ado-Ekiti, South Western Nigeria

Abstract

Early diagnosis and treatment achieved through Mammographic screening plays a key role in the reduction of breast related morbidities and mortalities in middle and low income countries. This study highlights the spectrum of digital mammography findings in a tertiary health institution in Ado-Ekiti, South western Nigeria. A cross-sectional descriptive study of clients who presented for digital mammography at a newly equipped hospital was conducted within a year. The mammograms were reviewed by two radiologists and overall imaging findings were classified using the American College of Radiology Breast Imaging Reporting and Data System (ACR-BIRADS). Data analysis was done using SPSS version 20.0. A total of 154 clients with age range of 37 to 85 years (mean age of 51± 9.6years) underwent mammography during the study period. There was one male and 153 females out of which 69(45.1%) were postmenopausal while 84(54.9%) were premenopausal. Major clinical indications for mammography included routine breast cancer screening (N= 59, 38.3%), breast lump (N= 43, 27.9%) and breast pain (N=34, 22.1%). Mammograms were normal in 37(24.0%), inconclusive in 51(33.1%) and abnormal in 66(42.9%) clients. Abnormal mammographic findings included various forms of calcifications (N=56, 36.4%), breast opacities/masses (N=42, 27.3%), axillary lymphadenopathy (N=14, 9.0%), focal glandular asymmetry (N=10, 6.5%) and architectural distortion (N=6, 3.9%). About 55(35.7%) patients underwent additional imaging with ultrasonography, out of which 32(58.2%) had positive sonographic findings. The use of ultrasonography for additional imaging in cases of inconclusive mammograms improves the diagnostic yield. A greater proportion of the clients had mammography done for diagnostic reasons rather than screening purposes. Hence there is the need for increased awareness of screening mammography among the women in resource constrained settings.