Ezeonu Paul Olisaemeka, Ajah Leonard Ogbonna, Onoh Robinson Chukwudi, Lawani Lucky Osaheni, Enemuo Vincent Chidi, Agwu Uzoma MaryRose
Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Department of Surgery, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Onco Targets Ther. 2015 May 13;8:1025-9. doi: 10.2147/OTT.S83437. eCollection 2015.
Breast cancer in pregnancy accounts for 2%-3% of all breast cancers. The increased vascularity and lymphatic drainage from the breast during pregnancy potentiate the metastatic spread of the cancer to the regional lymph nodes. However, the increased breast density in pregnancy makes it difficult to detect breast lesions early.
To evaluate and compare the detection rate of breast lesions using clinical breast examination (CBE) and breast ultrasonography among pregnant women.
A cross-sectional comparative study involving antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, was conducted between March 3, 2014, and December 31, 2014. CBE and breast ultrasonography were done in the participants at booking and repeated at 6 weeks postpartum. Fine-needle aspiration cytology and histology were done in women with suspicious breast lesions on CBE or breast ultrasonography or both. Data analysis was both descriptive and inferential at the 95% confidence level using the Statistical Package for the Social Sciences (SPSS) software version 17.0. Test of significance was done using chi-square test. A P-value of less than or equal to 0.05 was considered statistically significant.
A total of 320 pregnant women participated in the study. Of these, 267 (83.4%) were aware of breast cancer. Although more lesions were detected with breast ultrasonography than by CBE, there was no statistically significant difference between them (25 versus 17; P=0.26). The histology of the lesions revealed 21 benign lesions and 4 normal breast tissues. The sensitivity of breast ultrasonography was 95.2%, while that of CBE was 66.7%. The specificity, positive predictive value, and negative predictive value were similar between CBE and breast ultrasonography.
The detection rates of breast lesions by both CBE and breast ultrasonography were equivalent during pregnancy and 6 weeks postpartum, making CBE a convenient and very cost-effective method of detecting breast lesions in the low-risk population. However, both CBE and breast ultrasonography should be done in women with high risk of breast malignancy.
妊娠合并乳腺癌占所有乳腺癌的2%-3%。孕期乳房血管增多及淋巴引流增加，促使癌症转移至区域淋巴结。然而，孕期乳房密度增加使得早期发现乳房病变变得困难。
评估并比较孕妇中使用临床乳房检查（CBE）和乳房超声检查对乳房病变的检出率。
2014年3月3日至2014年12月31日，在阿巴卡利基联邦教学医院对产前门诊就诊者进行了一项横断面比较研究。在预约时对参与者进行CBE和乳房超声检查，并在产后6周重复检查。对CBE或乳房超声检查或两者检查发现乳房病变可疑的女性进行细针穿刺细胞学检查和组织学检查。使用社会科学统计软件包（SPSS）17.0版在95%置信水平下进行描述性和推断性数据分析。采用卡方检验进行显著性检验。P值小于或等于0.05被认为具有统计学意义。
共有320名孕妇参与研究。其中，267名（83.4%）知晓乳腺癌。虽然乳房超声检查发现的病变比CBE多，但两者之间无统计学显著差异（25例对17例；P=0.26）。病变组织学检查显示21例良性病变和4例正常乳腺组织。乳房超声检查的敏感性为95.2%，而CBE的敏感性为66.7%。CBE和乳房超声检查的特异性、阳性预测值和阴性预测值相似。
在孕期和产后6周，CBE和乳房超声检查对乳房病变的检出率相当，这使得CBE成为在低风险人群中检测乳房病变的一种方便且性价比很高的方法。然而，对于乳腺癌高危女性，CBE和乳房超声检查都应进行。
