Health worker led breast examination in rural India using electro-mechanical hand-held breast palpation device

Abstract

Introduction: Breast cancer is the most common female cancer worldwide representing nearly a quarter (23%) of all cancers in women. In India, breast cancer is the leading site of cancer. Due to, point of care pre-screening tool operated by community health workers. limitations of resources in India, breast screening is not done at regular intervals and is inaccessible in most parts of the country. The study was conducted with the aim to assess the feasibility of iBreastExam (iBE), a radiation free, painless, portable. Materials and methods: 1300 female subjects, above 30years were enrolled in the study over 6months and underwent both iBE and Clinical Breast Examination. Results: Out of 1420 women who were approached for the study, 1300(91.5%) consented for the study, indicating acceptability rate for the technique. 146(11.2%) women were positive on either or both modalities and underwent breast ultrasonography. 18 patients were found to have significant lesions on USG, for which they underwent breast fine needle aspiration cytology or biopsy and 3 breast cancers were confirmed. All patients who consented for the study, were comfortable taking iBE test due to its radiation free and painless nature. Conclusions: Breast examination by a radiation-free and painless electro-mechanical hand-held breast palpation device (iBreastExam) is socio-culturally acceptable in the rural environment. The device detected all clinically significant lumps. This study highlights the successful implementation of iBreastExam in the community setting and its potential for mass breast cancer screening in rural environment.

The iBreastExam versus clinical breast examination for breast evaluation in high risk and symptomatic Nigerian women: a prospective study

“…We found that the iBreastExam positivity was greater than previously reported; 23 however, given that 64% of our population was symptomatic, a higher positivity rate is not unexpected. For clinical use, higher iBreastExam positivity might be more acceptable in evaluating symptomatic women than screening asymptomatic women.…”

“…Initial iBreastExam studies [19][20][21][22][23][24] are promising, reporting 84-87% sensitivity, 80-94% specificity, and high negative predictive values (NPV; 94-98%). The iBreastExam can possibly provide a standardised breast examination with a report to facilitate physician communication.…”

Experience and yield of mass breast screening among working women in major cities of India: a mixed-method study

“…Khandelwal had 146 (11.2%) yield when iBE or Clinical Breast Examination (CBE) was done. 17 Kerlikowske et al found that the with screening mammography in their study was 7%. 8 Kumar et al found the yield to be 5.1% on mammography.…”

“…Breast examination by a radiation-free and painless electro-mechanical handheld breast palpation device (iBreast TM ). 17 It is important to catch breast cancer at its earlier stage as it leads to better survival rate, reduces the cost of treatment and the overall burden of breast cancer, which is especially needed in developing countries like ours. 19 The iBreast TM has a potential to be a promising tool in providing effective diagnosis after breast examinations even in young women with dense breasts.…”

iBreastExam: Time for Formal Operation in Nepal

“…In a study by Rohan Khandewal, iBreastExam detected all clinically significant lumps and was socioculturally acceptable in the rural environment because it is portable, radiation-free, and painless making it a potential mass screening device in low-resource settings. 9 The study by Somashekar et al showed significantly better sensitivity of iBreastExam by 19% than CBE in the detection of breast lesions and also reported high specificity (94%) and negative predictive value (98%). Most importantly, iBreastExam demonstrated high-performance characteristics in younger women younger than 40 years with high dense breast prevalence.…”