Statistical Comparison of Clinical and Histologic Diagnoses of Breast Tumours in Public and Private Hospitals

Background: Breast cancer is the leading cause of cancer deaths in Nigerian women. Most cases present in late or advanced stages with consequent poor prognosis. There are also instances of false clinical diagnoses with resultant patient adversity. Population screening based on genetics is largely unavailable to the citizens. Therefore, early diagnosis is the immediate choice available to the health system.Methods: Retrospective data were collected including all open-breast-biopsies submitted to three histopathology laboratories. The clinical and histologic diagnoses for each sample were compared. Statistical estimate of the accuracy of clinical diagnoses of breast cancer by clinicians was calculated using histologic diagnoses as the reference standard, and by calculating the sensitivity, specificity, false rates and odds ratio. Diagnostic accuracies of clinicians working in public and private hospitals were also compared in terms of these rates.Results: Our result showed that the diagnostic accuracy of the doctors working in public hospitals is more sensitive than that of those working in private hospitals. The overall false positive rate in both hospital groups combined is found to be high. This is probably due to unavailability of modern radiodiagnostic facilities that may otherwise enhance clinical assessment and diagnoses. The doctors in the public hospital group are generally more efficient in breast cancer diagnoses than those working in private hospitals.Conclusion: The authors believe that better funding of the audited hospitals, regular training of the medical personnel and provision of modern radiodiagnostic facilities may probably enhance clinical accuracy of breast cancer diagnoses in these hospitals