Breast Cancer Risk Factors and Breast Complaints Among Kenyan Women

PURPOSE To estimate the prevalence of breast complaints (discharge, mass, pain, skin changes, breast asymmetry) and well-established risk factors for breast cancer (BC) in Kenyan women who underwent clinical breast examinations (CBE) and determine the relationship between breast complaints and hormonal and lifestyle factors. METHODS This was a cross-sectional analysis of data from community screening events held between 2019 and 2020 in Kenya. A total of 2,117 women older than 18 years were included in the analysis after exclusions for age and lack of CBE findings (n = 97). The main outcome was estimated prevalence of breast complaints. Multivariable logistic regression analysis was applied to assess factors associated with breast complaints. RESULTS Of 2,117 women, 23% (486) reported breast complaints. Prevalence of BC risk factors included late pregnancy (1.5%), personal history of BC (2.6%), family history of BC (7.0%), early menarche (9.6%), nulliparity (17.1%), smoking (7.1%), and alcohol consumption (27.9%). Women with a previous breast biopsy and those with a personal history of BC had significantly higher odds of reporting breast complaints (adjusted odds ratios AOR, 2.99 95% CI, 1.65 to 5.40 and AOR, 2.00 95% CI, 1.08 to 3.68, respectively). CONCLUSION The prevalence estimates for breast complaints were concerning, whereas those for well-established risk factors for BC were low. The likelihood of reporting breast complaints was higher among women with a history of BC. Surveillance systems should be established for women who report breast complaints during community screening events, including further diagnostics for benign breast diseases. This study is among the first to assess breast complaints to advance the understanding of BC risk in Kenyan women and to provide recommendations for follow-up during BC screening community events.