scholarly journals Impact of Community-Based Clinical Breast Examinations in Botswana

2021 ◽  
pp. 17-26
Author(s):  
Michael Dykstra ◽  
Brighid Malone ◽  
Onica Lekuntwane ◽  
Jason Efstathiou ◽  
Virginia Letsatsi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Screening Program ◽  
Breast Cancer Mortality ◽  
Clinical Breast Examination ◽  
Breast Cancer Diagnosis ◽  
Community Based ◽  
Middle Income ◽  
Clinical Breast ◽  
Clinical Breast Examinations

PURPOSE We evaluated a clinical breast examination (CBE) screening program to determine the prevalence of breast abnormalities, number examined per cancer diagnosis, and clinical resources required for these diagnoses in a middle-income African setting. METHODS We performed a retrospective review of a CBE screening program (2015-2018) by Journey of Hope Botswana, a Botswana-based nongovernmental organization (NGO). Symptomatic and asymptomatic women were invited to attend. Screening events were held in communities throughout rural and periurban Botswana, with CBEs performed by volunteer nurses. Individuals who screened positive were referred to a private tertiary facility and were followed by the NGO. Data were obtained from NGO records. RESULTS Of 6,120 screened women (50 men excluded), 452 (7.4%) presented with a symptom and 357 (5.83%) were referred for further evaluation; 257 ultrasounds, 100 fine-needle aspirations (FNAs), 58 mammograms, and 31 biopsies were performed. In total, 6,031 were exonerated from cancer, 78 were lost to follow-up (67 for ≤ 50 years and 11 for > 50 years), and 11 were diagnosed with cancer (five for 41-50 years and six for > 50 years, 10 presented with symptoms). Overall breast cancer prevalence was calculated to be 18/10,000 (95% CI, 8 to 29/10,000). The number of women examined per breast cancer diagnosis was 237 (95% CI, 126 to 1910) for women of age 41-50 years and 196 (95% CI, 109 to 977) for women of age > 50 years. Median time to diagnosis for all women was 17.5 [1 to 32.5] days. CBE-detected tumors were not different than tumors presenting through standard care. CONCLUSION In a previously unscreened population, yield from community-based CBE screening was high, particularly among symptomatic women, and required modest diagnostic resources. This strategy has potential to reduce breast cancer mortality.

scholarly journals Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru

JAMA Oncology ◽  
2017 ◽  
Vol 3 (11) ◽  
pp. 1563 ◽  
Author(s):  
Anya Romanoff ◽  
Tara Hayes Constant ◽  
Kay M. Johnson ◽  
Manuel Cedano Guadiamos ◽  
Ana María Burga Vega ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Clinical Breast Examination ◽  
Breast Cancer Diagnosis ◽  
Breast Examination ◽  
Clinical Breast

scholarly journals A Community-Based Clinical Breast Examination Program: Is it Feasible?

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 36s-36s
Author(s):  
Ranjit K. Pritam Singh ◽  
Zainab Abdullah ◽  
Salimah Saleh
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Conflicts Of Interest ◽  
Clinical Breast Examination ◽  
Outreach Program ◽  
Breast Lump ◽  
Community Based ◽  
Breast Examination ◽  
Clinical Breast ◽  
Palpable Breast

Purpose Breast cancer presents in advanced stages in low- and middle-income countries where screening mammography is not available. In Malaysia, almost 60% of women, particularly in those the low socioeconomic group, present with stage III and IV breast cancer. We evaluated the feasibility of a community-based early detection program using clinical breast examination (CBE) carried out by the Breast Cancer Welfare Association, a nongovernmental organization. Methods Using a mobile clinic that was equipped to carry out CBE, a team of six health professionals trained in CBE techniques reached out to urban poor communities on the outskirts of the city and the rural population at the invitation of community leaders. At these events, breast self-awareness was taught to the community, with particular regard to the signs and symptoms of breast cancer and to breast self-examination. CBE was carried out in those women who agreed to be examined. Women who were found to have breast lumps were referred to the nearest public hospital and were observed for compliance. Women with anxiety were counseled. Results In 2016 to 2017, CBE was performed for 7,503 women, and 295 (3.9%) were found to have a palpable breast lump. These women were referred to the nearest hospital for additional assessment. Of these women, 156 (52.9%) consulted the doctor and sought additional examination. A total of 153 patients had no malignant findings, whereas three were found to have breast cancer. The mean age for women found to have a palpable breast lump was younger than 40 years—35 years in 2016 and 33 years in 2017—whereas the median age among the 295 women was 33 years in 2016 and 31 years in 2017 (range, 17 to 67 years). Conclusion A community outreach program using CBE as a method of early detection is feasible in Malaysia. Additional study is required to determine why 47% of those who were found to have a breast lump did not seek additional assessment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

scholarly journals Clinical Utility of a Hand-Held Scanner for Breast Cancer Early Detection and Patient Triage

2020 ◽  
pp. 27-34 ◽  
Author(s):  
Julie M. Clanahan ◽  
Sanjana Reddy ◽  
Robyn B. Broach ◽  
Anne F. Rositch ◽  
Benjamin O. Anderson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Low Cost ◽  
Clinical Breast Examination ◽  
Population Based ◽  
Mammographic Screening ◽  
Diagnostic Workup ◽  
Middle Income ◽  
Cancer Early Detection ◽  
Early Cancer Diagnosis ◽  
Clinical Breast

PURPOSE Globally, breast cancer represents the most common cause of cancer death among women. Early cancer diagnosis is difficult in low- and middle-income countries, most of which are unable to support population-based mammographic screening. Triage on the basis of clinical breast examination (CBE) alone can be difficult to implement. In contrast, piezo-electric palpation (intelligent Breast Exam [iBE]) may improve triage because it is portable, low cost, has a short learning curve, and provides electronic documentation for additional diagnostic workup. We compared iBE and CBE performance in a screening patient cohort from a Western mammography center. METHODS Women presenting for screening or diagnostic workup were enrolled and underwent iBE then CBE, followed by mammography. Mammography was classified as negative (BI-RADS 1 or 2) or positive (BI-RADS 3, 4, or 5). Measures of accuracy and κ score were calculated. RESULTS Between April 2015 and May 2017, 516 women were enrolled. Of these patients, 486 completed iBE, CBE, and mammography. There were 101 positive iBE results, 66 positive CBE results, and 35 positive mammograms. iBE and CBE demonstrated moderate agreement on categorization (κ = 0.53), but minimal agreement with mammography (κ = 0.08). iBE had a specificity of 80.3% and a negative predictive value of 94%. In this cohort, only five of 486 patients had a malignancy; iBE and CBE identified three of these five. The two cancers missed by both modalities were small—a 3-mm retro-areolar and a 1-cm axillary tail. CONCLUSION iBE performs comparably to CBE as a triage tool. Only minimal cancers detected through mammographic screening were missed on iBE. Ultimately, our data suggest that iBE and CBE can synergize as triage tools to significantly reduce the numbers of patients who need additional diagnostic imaging in resource-limited areas.

Original Paper: Contribution of clinical breast examination to mammography screening in the early detection of breast cancer

2003 ◽  
Vol 10 (1) ◽  
pp. 16-21 ◽  
Author(s):  
C Bancej ◽  
K Decker ◽  
A Chiarelli ◽  
M Harrison ◽  
D Turner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Breast Cancer Mortality ◽  
Clinical Breast Examination ◽  
Screening Mammography ◽  
Detection Rates ◽  
Breast Examination ◽  
Mode Of Detection ◽  
Clinical Breast ◽  
Interim Measures

Objectives: As the benefit of clinical breast examination (CBE) over that of screening mammography alone in reducing breast cancer mortality is uncertain, it is informative to monitor its contribution to interim measures of effectiveness of a screening programme. Here, the contribution of CBE to screening mammography in the early detection of breast cancer was evaluated. Setting: Four Canadian organised breast cancer screening programmes. Methods: Women aged 50-69 receiving dual screening (CBE and mammography) (n=300,303) between 1996 and 1998 were followed up between screen and diagnosis. Outcomes assessed by mode of detection (CBE alone, mammography alone, or both CBE and mammography) included referral rate, positive predictive value, pathological features of tumours (size, nodal status, morphology), and cancer detection rates overall and for small cancers (≤10 mm or node-negative). Heterogeneity in findings across programmes was also assessed. Results: On first versus subsequent screen, CBE alone resulted in 28.5-36.7% of referrals, and 4.6-5.9% of cancers compared with 52.6-60.1% of referrals and 60.0-64.3% of cancers for mammography alone. Among cancers detected by CBE, 83.6-88.6% were also detected by mammography, whereas for mammographically detected cancers only 31.7-37.2% were also detected by CBE. On average, CBE increased the rate of detection of small invasive cancers by 2-6% over rates if mammography was the sole detection method. Without CBE, programmes would be missing three cancers for every 10,000 screens and 3-10 small invasive cancers in every 100,000 screens. Conclusions: Inclusion of CBE in an organised programme contributes minimally to early detection.

The Economic Impact of Breast Cancer in the South-East Asian Region

2019 ◽  
pp. 298-306
Author(s):  
Merel Kimman ◽  
Sanne Peters ◽  
Stephen Jan ◽  
Nirmala Bhoo-Pathy ◽  
Cheng Har Yip ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
East Asian ◽  
Breast Cancer Diagnosis ◽  
Economic Consequences ◽  
South East Asia ◽  
Middle Income ◽  
South East Asian Region ◽  
East Asian Region ◽  
The World

Abstract: In many parts of the world, are not only the economic consequences of breast cancer a burden to society, but also patients and their families directly endure financial hardship after a breast cancer diagnosis. This chapter examines the economic consequences of breast cancer for patients and families in a low- and middle income setting. Results of a study on financial catastrophe and mortality after breast cancer diagnosis, conducted in several countries in South-East Asia, are described.

scholarly journals ASSESSING BREAST DISORDERS AND FEASIBILITY OF BREAST-I LED MACHINE AMONG WOMEN OF RURAL AREA OF CHANDIGARH, INDIA

2021 ◽  
Vol 9 (03) ◽  
pp. 379-384
Author(s):  
Anjali Sharma ◽  
Shushma Kumari Saini ◽  
Kmendalin Nongspung ◽  
Meenakshi a ◽  
Arti b ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Data Entry ◽  
Clinical Breast Examination ◽  
Interview Schedule ◽  
Breast Examination ◽  
Clinical Breast ◽  
History Of ◽  
Clinical Breast Examinations ◽  
High Level

Background: Breast cancer is the most common cancer in India causing highest cancer deaths in India as per GLOBOCAN 2018. Early diagnosis and treatment helps in improving prognosis and prolonging life. BREAST-i LED machine is one of the technology, for screening breast cancer at early stage. The present study was undertaken to evaluate the feasibility of BREAST-i LED machine to screen breast cancer. Methods: Across-sectional study was conducted on 300 convenient selected women in the age group of 30-60 years. Data was collected by house-to-house survey and all the women in surveyed house were registered for the study. They were interviewed as per the interview schedule comprised of a) Socio-demographic profile b) reproductive profile c) cancer related history and sign/symptoms. . By using BREAST-i LED machine the breast examination was done and the clinical breast examination was done there after to screen any sign of breast cancer. Identified cases were referred for confirmation of diagnosis. The data entry and analysis was done on SPSS (version 20). Results: The majority of the participants were between the age of 40-50years (42%) and majority of them (89.33%) began their menstruation between the age of 11-15 years. More than half (53.66%) had their first pregnancy between the age of 21-30years More than half (58%) had not attained their menopause and 99.3% had no family history of breast cancer. A high level of suspicion of breast cancer using Breast-i-LED instrument was found among four women (1.33%). Same results were observed by clinical breast examinations as well. These women were referred for further confirmation of diagnosis. Conclusion: BREAST-i LED machine can be used in community for quick screening of suspicion of breast cancer.

scholarly journals Employment Challenges Faced by Breast Cancer Survivors in an Upper Middle–Income Asian Setting

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 119s-119s
Author(s):  
Y.-C. Kong ◽  
N.T. Bhoo-Pathy ◽  
L.-P. Wong ◽  
A.F. Aziz ◽  
N.A. Taib ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Return To Work ◽  
Cancer Survivors ◽  
Work Environment ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Income Loss ◽  
Middle Income ◽  
Number Of Patients

Background: Cancer survivorship as an area, which focuses on the health and life of an individual following cancer diagnosis and treatment is increasingly being recognized as an important component of the cancer control continuum. Advances in breast cancer detection and treatments have resulted in a growing number of patients experiencing a breast cancer diagnosis at an age when career plays an important role in their lives. Yet, very little is known on how breast cancer affects employment and return to work among survivors, particularly in low- and middle-income settings. Aim: This qualitative study aims to gain an in-depth understanding on employment challenges and motivators/barriers in return to work faced by breast cancer survivors in an upper-middle income Asian setting. Methods: Eleven focus group discussions (FGDs) were conducted with breast cancer survivors representing various ethnicities and socioeconomic backgrounds in Malaysia. Patients diagnosed one to two years prior to the study were recruited from a general public hospital, a public academic hospital and two private hospitals. Data from the FGDs were examined using thematic content analysis from the NVivo software. Results: The major themes relating to impact of cancer diagnosis on employment were “decreased work ability”, “job loss”, “long absenteeism” and “hostile work environment”. Coping strategy themes frequently mentioned to offset income loss from employment changes were “savings”, “part-time work” or financial support from “family/friends” or “social security”. However, participants were quick to highlight the insufficiency and unreliability of these strategies to cope financially in the long run. When describing their decision in choosing to return to work, participants mentioned themes such as “need money”, feeling “more happy” or having a “supportive work environment”. Nonetheless, participants emphasized the “discrimination” they faced in finding a job after active treatment. Specifically, participants' frequent need to take time-off from work for their cancer follow-ups as well as their older age were perceived as disadvantages in seeking employment when compared with younger, healthy applicants. Conclusion: It is evident that a breast cancer diagnosis severely disrupts employment and return to work in middle income settings. Multisectoral interventions are urgently required to improve the employment status of our cancer survivors, including legislative reforms to prevent discrimination. Programs supporting employment and return to work among cancer survivors should be developed and integrated in the provision of a holistic survivorship care.

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