Characteristics of Breast Masses of Female Patients Referred for Diagnostic Breast Ultrasound from a Saudi Primary Health Care Setting

Nouf A AlShamlan,¹ Reem S AlOmar,¹ Omar Y Almukhadhib,² Saad A Algarni,² Askar K Alshaibani,² Sara A Elmaki,³ Malak A Al Shammari,¹ Abdulaziz M Sebiany<sup>1

1</sup>Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; ²College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; ³Department of Radiology at Family and Community Medicine Center, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Correspondence: Nouf A AlShamlan
Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Tel +966504901406
Email [email protected]

Background: Breast masses are common among females presenting to primary health care (PHC) facilities. The family physician’s role is crucial in detecting breast disease. Utilization of breast ultrasonography has been increasing recently as a diagnostic tool.
Objective: This study aims to determine the characteristics of masses detected on breast ultrasound, their associations with characteristics of females attending the PHC setting and explore the management of these cases by family physicians.
Methods: This registered based, cross-sectional study included 321 females who were referred for diagnostic breast ultrasound in the PHC center of the University hospital, Eastern province, Saudi Arabia (2017– 2019). t-test, Chi-squared and Fisher’s Exact tests were performed to assess associations between the presence of breast masses in the ultrasound and patients’ characteristics. Moreover, to compare the breast masses in two groups of patients (< 40 years and ≥ 40 years) regarding their characteristics, ultrasound findings, and further management performed. P < 0.05 was considered statistically significant.
Results: Approximately 24% patients had a breast mass and 70.92% of cases were detected among females ≥ 40 years old. The odds of having a breast mass were highest among overweight, females complaining from a breast lump, and who had early menarche. Grand multiparous had lower odds of a breast mass. Females < 40 years old had higher rates of breastfeeding, increasing parity, and obesity than older females. Sonographic examined masses were larger in young females, and posterior enhancement of the mass was more reported in older. BI-RADs of the masses were not associated with the patient’s age.
Conclusion: Breast masses were prevalent among females who underwent breast ultrasound. The results support referral for investigation when a female complains of a breast lump. Family physicians have a vital role in encouraging protective behaviors from developing breast masses such as maintaining normal weight and breastfeeding.

Keywords: breast, mass, ultrasound, primary care, family physician