# Breast Disease Patterns Among Patients Presenting for Mammography in a Major Hospital in the Volta Region of Ghana: A Five-Year Descriptive Retrospective Study

## TL;DR

This study analyzed breast disease patterns in Ghanaian women who had mammograms, finding that most visits were for diagnosis rather than screening, with many cases showing benign issues.

## Contribution

The study provides a regional analysis of breast disease patterns in Ghana using recent mammography data, highlighting screening gaps and disease prevalence.

## Key findings

- Most women (93.75%) presented for diagnostic mammography rather than screening.
- Breast density was significantly associated with age, with 47.08% having scattered fibroglandular density.
- The majority of positive findings (74.54%) were classified as benign (BI-RADS 2 and 3).

## Abstract

Introduction: The practice of mammography has transitioned from analog to digital with improved accuracy and significant changes to findings. This study was aimed at investigating the current patterns of breast diseases among women presenting for mammography at a major hospital in the Volta region of Ghana.

Methods: This descriptive retrospective study reviewed 508 mammography and complimentary breast ultrasound reports conducted between October 2019 and May 2023. Because they were incomplete and had essential patient data missing, 28 reports (n = 28) were excluded. Data extracted from the reports included patients' age, clinical indication, breast density, imaging impression, and BI-RADS classification for each breast. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 26, and results are presented using descriptive and inferential statistics.

Results: The study involved 480 women, aged 40–86 years (mean = 54.6 ± 10.1). The distribution of the breast densities of the women was as follows: almost entirely fatty (n = 79, 16.46%), scattered areas of fibroglandular density (n = 226, 47.08%), heterogeneously dense (n = 145, 30.21%), and extremely dense (n = 30, 6.25%). There was a statistically significant association between age and breast density (p < 0.01). While 30 (6.25%) of the women presented for screening, 450 (93.75%) presented for diagnostic mammography. Breast pain (n = 189, 39.38%), breast lump/mass (n = 155, 32.29%), and suspected breast cancer (n = 47, 9.79%) were the most common clinical indications. The study recorded a total of 960 BI-RADS classifications of which 261 (27.19%) were negative and 699 (72.81%) were positive. Most of the positive findings (n = 521, 74.54%) were BI-RADS 2 and 3. Both benign and suspicious for malignancy or highly suggestive of malignancy lesions were common across women aged 40–50 years. There was a statistically significant association between age and BI-RADS classification (p < 0.01).

Conclusion: This study showed that most of the women presented for diagnostic mammography. Attendance for screening mammography was poor among women presenting for mammography at the hospital; hence, women should be encouraged through health education and other campaign strategies to undergo screening mammography more regularly to facilitate more timely detection and diagnosis of breast diseases. A third of the women in our study had dense breasts. The vast majority of the women had positive findings, but the majority of these findings were indicative of benign breast diseases.