Abstract:

The Usmanu Danfodiyo university teaching hospital is a regional tertiary center serving the North-western states of Sokoto, Zamfara, and Kebbi. It occasionally receives patients from neighboring Niger state. In recent times the hospital has recorded an increased number of patients presenting with breast diseases due perhaps to the following factors: increased patient awareness, increased number of trained personnel, improvement in diagnostic facilities, and the referral system. Unfortunately, the majority of the patients with malignant breast diseases present late with attendant poor outcomes. And with the rising patient population and dwindling finances, an idea of the spectrum of breast diseases and its burden in a resource-limited country like Nigeria will greatly enhance policy formulations to meet the challenges of providing quality health care for the people. Objectives: (i) To determine the clinical and histo-pathological pattern of breast diseases in Sokoto, Nigeria. (ii) To highlight the most frequently encountered histological subtype of breast lesions in this sub-region. Methodology: A prospective recruitment of consecutive patients with breast diseases presenting to the surgical clinic of the Usmanu Danfodiyo university teaching hospital, Sokoto, between 2014 and 2018 was carried out. Data obtained from administered questionnaires included socio-demographic characteristics and histopathological diagnosis. The results were analyzed using the windows SPSS statistics 20.0. Results: A total of 1822 patients with breast diseases were seen. This was made up of 1006 (55.2%) benign cases and 816 (44.8%) malignant cases. There was a relative annual increase in the number of cases of breast diseases seen over the five-year study period with 280 cases seen in 2014 and 430 cases seen in 2018. The overall male: female ratio for breast diseases was 1:304. Fibroadenoma accounted for 95.4% (960) of all cases of benign breast lesions seen, followed respectively by fibrocystic disease 1.8% (18), breast abscess 0.8% (8), duct papilloma 0.5% (5), duct ectasia 0.2% (2) and breast tuberculosis 0.1% (1). Fifty-one percent (488) of cases of fibroadenoma occurred between the ages of 11-20 years, while 42.8% (411) occurred between ages 21-30 years giving a mean age range of 21-30 years. Sixty-one percent (11) of fibrocystic disease occurred between ages 30-40 years. Invasive ductal carcinoma was the most commonly diagnosed malignant breast lesion accounting for 98% (800) of all malignant diseases. Invasive lobular carcinoma followed at 1.5% (12). Forty-five percent (362) of invasive ductal carcinoma occurred between the 41-50year age group. Conclusion: Fibroadenoma constitutes 95.4% (960) of benign breast diseases in Sokoto with a mean age range of 21-30 years followed by fibrocystic disease at 1.8% (18). Invasive ductal carcinoma constitutes 98% (800) of malignant breast diseases with a peak age range of 41-50 years followed by invasive lobular carcinoma at 1.5% (12).