Abstract B034: Assessment of the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia
Authors: Manamo Wondimu Ayele , Nuramo Adamu Addissie , Jemal Ahmedin , Taylor Lesley , Kantelhardt Eva J. 
Published: August 2020

Background: Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer death among females in Ethiopia. BC screening programs are lacking and above 80% breast cancer are diagnosed at advanced stages. Ultrasound-guided fine needle aspiration (FNA) is a simple and effective approach to evaluate breast mass in resource limited countries. The aim of this study was to assess the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia.

Methods: Community based cross-sectional study was conducted among 7,573 adult women, age 15 years and older from March to April 2018 in Butajira Health and Demographic Surveillance Site, South Central Ethiopia. A two stage-stratified cluster sampling method was used to select the population-based study participants. Data were collected using a pretested interviewer-administered questionnaire to inquire about breast abnormalities from eligible respondents. Further clinical assessment with history and physical examination of those reporting breast abnormalities (e.g., lump or breast pain) were assessed by experienced surgeons. If indicated, surgeons ordered the ultrasound-guided FNA performed by pathologist and cytologic analysis was done by an experienced pathologist. Women with BC were referred to Butajira Hospital for oncologic care. Data were analyzed using EPI- Info and SPSS V20. Descriptive statistics were used to summarize clinical and pathology result.

Result: Out of 7,573 women surveyed, 258 (3.4%) women with breast abnormality were identified and referred to the Butajira Health Center. Only two women had visited a health facility to seek medical care before the survey was administered. Of those who reported breast abnormalities, 246 (95.3%) women had physical examinations. Forty-nine women had findings requiring ultrasound-guided FNAs. The median age of women was 30 years old with interquartile range of 25-40 years. Of the FNAs performed, 13 (26.5%) were benign lesions, 8 (16.3%) were fibroadenomas, 9 (18.4%) were reactive lymphoid hyperplasia, and 14 (28.6%) were other noncarcinoma cases. One (2%) was suspicious of BC and required excisional biopsy for diagnosis, and 4 (8.2%) ascertained non-special type carcinoma of the breast. Of BC patients, 2 patients presented with ulcerated and fungating lesion with tumor size greater than 5cm, one patient presented with ulcerating tumor measuring 3 cm, and two patients presented with a breast mass measuring 4 cm.

Conclusion: A few women with self-reported breast abnormalities in a rural region of Ethiopia sought medical attention for their problem prior to our survey. We found the prevalence of women with breast abnormalities in our population-based study was similar to reports from Liberia and Rwanda. Raising awareness of health care services available to women in rural regions of Ethiopia could increase earlier detection of breast cancer and improve quality of life.

Citation Format: Wondimu Ayele Manamo, Adamu Addissie Nuramo, Ahmedin Jemal, Lesley Taylor, Eva J. Kantelhardt. Assessment of the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B034.