Breast cancer early detection methods for low and middle income countries, a review of the evidence

Abstract

Organized national mammographic screening has been adopted as the gold standard for breast cancer early detection in western countries; however it may not be the most cost-effective approach to early detection in low and middle income countries (LMC) as it is very demanding in terms of human and financial resources. Moreover, its benefit to harm ratio has been questioned lately, particularly in women <50 years, the age group which produces the majority of breast cancer cases in LMC. In the past few years, evidence about alternatives to mammographic screening that would benefit LMC populations have been produced. They are reviewed and discussed in the present paper, together with evidence about mammographic screening relevant to LMC. Alternative screening tests (clinical breast-exam and self breast-exam) are examined, then the pro- and cons- for various strategies (opportunistic screening, population based screening and clinical downstaging) are discussed.

Determinants of Participation in a Breast Cancer Screening Trial in Trivandrum District, India

“…BSE alone did not show a decrease in mortality or down-staging of advanced cancer in earlier clinical trials, but is expected to increase breast cancer awareness and might help to decrease tumour size and stage at diagnosis in settings where women mainly present with late stages (Garg et al, 2010;Mittra, 2011;Corbex et al, 2012;Panieri, 2012).…”

Predictors Affecting Breast Self-Examination Practice among Turkish Women

“…Ghazali et al stated that females who never practice BSE in their lives were more likely to be diagnosed with the delay of BC compared to those who regularly implemented BSE (Ghazali et al, 2013). It may lead to increase the BC awareness and might lessen the malignancy stage at admission period in a location where women especially could not take advantage of early diagnostic methods including clinical breast examination, mammography, and ultrasonography (Parvani, 2011;Corbex et al, 2012;Panieri, 2012). Moreover, BSE is a non-invasive intervention carried out by females themselves without any support of medical health-care providers.…”

Imperfect Correlation of Mammographic and Clinical Breast Tissue Density

“…:http://dx.doi.org/10.7314/APJCP.2013.14.6.3685 Relation between Mammographic and Clinical Breast Density Every screening and diagnostic imaging entails some costs for the health system. This has triggered many arguments regarding the cost-effectiveness of screening, the issue has been debated further in developing countries where alternative approaches as opportunistic screening and screening by clinical or even self breast exam have been proposed (Corbex et al, 2012).…”

“…Breast examination is an essential component of breast cancer screening and diagnosis (Corbex et al, 2012;Bryan and Snyder, 2013). During the examination, the physician assumes an opinion about the degree of tissue firmness and unconsciously interprets it as equal to breast density in mammographic images.…”