Breast cancer screening: review of benefits and harms, and recommendations for developing and low-income countries

Al‐Foheidi, Meteb; Al‐Μansour, Mubarak; Ibrahim, Ezzeldin M.

doi:10.1007/s12032-013-0471-5

Cited by 43 publications

(31 citation statements)

References 102 publications

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“…In addition, there is data emerging from HICs that apparently denotes that implementation of screening mammography at the population level has led to probable overdiagnosis while only marginally reducing the rate at which women presented with advanced cancer, consequently having only a small effect on rate of death due to BC [40] . Similar evidence has been accumulated from multiple other studies [41,42] and adds to the ongoing discourse regarding the usefulness of population level BC screening using mammography [43] . Adding to the above scenario is the fact that in LMICs, BC incidence is lower and occurs more in younger age groups when breast tissue is dense.…”

Section: Status Of Mammography In Lmicssupporting

confidence: 62%

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Dey¹

2014

WJCO

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To review the present status of breast cancer (BC) screening/early detection in low-and middle-income countries (LMICs) and identify the way forward, an open focused search for articles was undertaken in PubMed, Google Scholar and Google, and using a snowball technique, further articles were obtained from the reference list of initial search results. In addition, a query was put up on ResearchGate to obtain more references and find out the general opinion of experts on the topic. Experts were also personally contacted for their opinion. Breast cancer (BC) is the most common cancer in women in the world. The rise in incidence is highest in LMICs where the incidence has often been much lower than high-income countries. In spite of more women dying of cancer than pregnancy or childbirth related causes in LMICs, most of the focus and resources are devoted to maternal health. Also, the majority of women in LMICs present at late stages to a hospital to initiate treatment. A number of trials have been conducted in various LMICs regarding the use of clinical breast examination and mammography in various combinations to understand the best ways of implementing a population level screening/early detection of BC; nevertheless, more research in this area is badly needed for different LMIC specific contexts. Notably, very few LMICs have national level programs for BC prevention via screening/early detection and even stage reduction is not on the public health agenda. This is in addition to other barriers such as lack of awareness among women regarding BC and the presence of stigma, inappropriate attitudes and lack of following proper screening behavior, such as conducting breast self-examinations. The above is mixed with the apathy and lack of awareness of policy makers regarding the fact that BC prevention is much more cost-effective and humane than BC treatment. Implementation of population level programs for screening/early detection of BC, along with use of ways to improve awareness of women regarding BC, can prove critical in stemming the increasing burden of BC in LMICs. Use of newer modalities such as ultrasonography which is more suited to LMIC populations and use of mHealth for awareness creation and increasing screening compliance are much needed extra additions to the overall agenda of LMICs in preventing BC.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Breast cancer; Screening; Early detection; Mammography; Clinical breast examination; Breast self examination; Ultrasonography; Awareness; Developing countries; Low-and middle-income countries Core tip: Implementation of population level breast cancer (BC) screening/early detection programs will prove to be most cost-effective for low-and middleincome countries (LMICs). Accompanying awareness creation regarding BC among women, more research and change in policy are also necessary to reduce the burden of BC in LMICs.Dey S. Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal.

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Section: Status Of Mammography In Lmicssupporting

confidence: 62%

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Dey¹

2014

WJCO

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“…Statistics indicate that global burden of disease (GBD) of various cancers is increasing in developing countries and this ratio is predicted to increase in the coming decades (Al-Foheidi et al, 2013). It is estimated that by 2008, 690000 out of 1380000 new cases of breast cancer are in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

Keyhani

Muhammadnejad²,

Behjati³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Breast cancer is the most common malignancy among women in both developed and developing countries. The burden is increasing in low-income and middle-income countries (LMCs) and threatens the public health of such societies. Introduction of expensive monoclonal antibodies to cancer treatment regimens poses a real challenge in the health systems of LMCs. Despite controversy of cost-effectiveness of bevacizumab in breast cancer, some studies indicate gain of patients from this drug. The present study aimed to propose a priority setting model for administration of anti-angiogenic agents in breast cancer via assessment of tumor angiogenesis by the microvessel density (MVD) method and associations with clinicopathological characteristics (including simultaneous mutations of TP53 and HER-2 genes). Materials and Methods: Age, axillary lymph nodes status, tumor size, stage and grade, estrogen and progesterone receptors status, HER-2/neu status (by immunohistochemistry and FISH test), TP53 mutation, Ki-67 (for proliferation assay) and CD34 (for angiogenesis assay) were assessed in 111 breast cancer patients. The molecular subtype of each tumor was also determined and correlations of simultaneous mutations of HER-2 and p53 genes with angiogenesis and other clinicopathological characteristics were evaluated. Results: There were significant associations between simultaneous mutations of HER-2 and p53 genes and all other parameters except tumor size. The degree of angiogenesis in the ERBB2 subtype was greater than the others. Younger patients showed a higher angiogenesis rate rather those older than 50 years. Conclusions: Our results demonstrated that patients with simultaneous mutations of HER-2 and p53 genes, those with ERBB2 molecular subtype and also younger women (often triple negative) seem more eligible for obtaining anti-angiogenic agents. These results suggest a model for priority setting of patients with breast cancer for treatment with anti-angiogenic drugs in LMCs.

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“…Although universal mammography screening is the most widely adopted approach to population-based screening, comparative effectiveness research focused on different screening strategies is still important owing to the enduring debate over the value of mammography screening. While some systematic reviews have concluded that mammography screening is associated with a 20% to 25% reduction in breast cancer deaths, 1,[5][6][7][8][9][10] other reviews claim that there is no benefit 11- 17 and also express concerns that universal mammography screening leads to significant harms, specifically overdiagnosis, sometimes called overdetection of breast cancer.…”

mentioning

confidence: 99%

Population-Based Breast Cancer Screening With Risk-Based and Universal Mammography Screening Compared With Clinical Breast Examination

et al. 2016

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Breast cancer screening: review of benefits and harms, and recommendations for developing and low-income countries

Cited by 43 publications

References 102 publications

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

Population-Based Breast Cancer Screening With Risk-Based and Universal Mammography Screening Compared With Clinical Breast Examination

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