Reviewer’s report
Title: 
Distribution of breast lesions diagnosed by cytology examination in
symptomatic patients at Eritrean National Health Laboratory, Asmara, Eritrea: a
retrospective study
Version: 
0 
Date: 
23 Nov 2019
Reviewer: 
Solomon 
Gebrehiwot
Reviewer's report:
BMWH-D-19-00520 
Reviewer report 
Name of the reviewer: Solomon Weldemariam 
This is my first revision 
Thank you for the opportunity to review this manuscript.
The authors sought to understand ''General Trends of Breast Diseases Diagnosed
by Cytological Examination in Symptomatic Patients at Eritrean National Health
Laboratory, Asmara, Eritrea; A Retrospective Study''. While this attempt will
add to knowledge on the topic, I have the following concerns and
recommendation.
General: 
The quality of written English is acceptable for publication. 
Title: the tile is attractive to readers but it is not explanatory of the analysis
results.
Authors couldn't show us the result of trend analysis in time series, which means
the distribution of the disease bay time. It doesn't show whether the disease
increasing from year to year or decreasing during the period. 
Therefore, either
they should recast the title 
''as Distribution of Breast Diseases Diagnosed by
Cytological Examination in Symptomatic Patients at Eritrean National Health
Laboratory, Asmara, Eritrea; A Retrospective Study'' 
or they have to improve the
analysis part to show us trend of the disease by time using trend graphs and
texts. 
Abstract: 
1. The abstract is acceptable but usually it is not recommended to use
abbreviations in this section. 
2. I recommend authors to include the rationale of the study in the background
section 
Background section: 
1. Paragraph found between line numbers 59 up to 67 which describes about the
health laboratory I recommend to include in the methodology section
particularly, in study setting. 
Method section:
1. Study setting should be described in detail under the topic 'study setting and
study design' line 76. 
Paragraph found between line numbers 59 up to 67 should
come here under this topic 
2. The study period should be specific which is found between line 84-85
3. Under the exclusion criteria, first, why you excluded individuals who were not
Eritrean nationals if they are living in Eritrea. Second, it is not clear for me
sentences found between line numbers 103-104 that ''those patients with already
established diagnosis of breast cancer with or without treatment were not
included''. Do you mean that there is a situation that patients already diagnosed
with cancer before come again for cytological examination to Eritrean National
Health Laboratory center? 
Result section:
1. I recommend authors to describe Trends of Breast Diseases by time using
graphs and texts to align with their topic 
Discussion: 
1. I recommend authors to discuss in detail their findings. It is a little beat
shallow. They tried to support their findings with findings of other literatures but
they couldn't justify their findings. For example, why benign breast lesions were
common in subjects aged 40 years and below On the contrary, why malignant
breast lesions were seen in those above 40 years old and the like.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
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salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
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gain or lose financially from the publication of this manuscript, either now
or in the future?
3
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Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
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Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
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Do you have any other financial competing interests?
6
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paper?
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