Background

Breast cancer is among the most common cancers affecting women worldwide, including Egypt. Age is a well-known determinant of breast cancer risk; however, more data is needed to better understand the importance of age on incidence of breast cancer in the Middle East. Being overweight or obese are also known risk factors—especially for post-menopausal women–however, these data are not available for women in developing countries.

Purpose

The purpose of this study was to qualitatively explore the association between age, breast density, and demographic factors of breast cancer patients, across a spectrum of radiological breast diagnoses at a large Breast Imaging Clinic in Cairo, Egypt.

Materials and Methods

We explored the association between age, demographic factors, and Breast cancer incidence among 6,711 women undergoing mammographic screening over a consecutive period of 6-years. Data was collected from March 2007 until March 2013 and extracted

from an electronic data base system.

Results

A total of 6,711 participants were included in this study. The median age of all patients was 46.1. Mean body mass index (BMI) of 28.5, where 34% of the patients were overweight and 32.4% were obese. Older women were more likely to be obese compared to younger women (38.4% vs 18.1%, p<0.001). Older females were more likely to have less dense breasts (ACR: A) compared to younger females (18.1% vs 8.7%, p<0.001). Women older than 40 had a higher confirmed number of breast cancer diagnoses compared with the younger age group (10.7% vs 3.5%, p<0.001). Women with breast cancer were more obese (p<0.001), had denser breasts (p<0.001), were post-menopausal (p=0.002), and more likely to be Muslim (p=0.0021). In the multivariate analysis, aforementioned factors were significant predictors for confirmed diagnosis.

Conclusion

To our knowledge this is the largest study to examine the association of radiological breast assessments on breast cancer incidence, obesity and demographic factors in Egypt. Although data shows the global burden of breast cancer is shifting to the developing world and affecting younger women at alarming rates, our data demonstrated a very low occurrence of breast cancer in both age groups.

Keywords

Breast cancer; Breast radiological diagnoses; Phenotypic variations; Breast imaging-reporting and data system (BI-RADS).

Introduction

The Breast Imaging-Reporting and Data System (BI-RADS) is a classification system aimed at standardizing risk assessment during breast ultrasound to ensure patient safety. BI-RADS is currently used in Uganda so as to standardize breast ultrasound reporting and enhance patient management.

Objective

This study aimed at exploring staff perceptions towards the use of the BI-RADS ultrasound characterization of breast masses.

Methodology

It was an exploratory qualitative study that involved staff who perform breast ultrasound at Mulago Hospital in Uganda. Focus group discussions and individual interviews were conducted.

Findings

All staff used the BI-RADS system, however, some of them had a negative attitude towards BI-RADS. The three major themes that emerged were: standardization of breast ultrasound reporting for patient safety; need for more Continuous Professional Development (CPD) and challenges with the BI-RADS system.

Conclusion

The study demonstrated that the staff generally had positive perceptions and attitude of the BI-RADS system and felt that it was an efficient system for ensuring patient safety and further reduce mortality from breast cancer.

Keywords

Breast imaging-reporting and data system (BI-RADS); Breast; Ultrasound; Staff perceptions.