Evaluation of the Knowledge Level of Family Medicine Residents about Mammography and Breast Cancer Screening Programs

Aim: It was aimed to evaluate the level of knowledge of family medicine residents about breast cancer screening program national standards and mammography. Methods: In this cross-sectional study, an online questionnaire was used to measure the knowledge level of family medicine resident doctors about breast cancer and mammography. In addition to demographic information, the questionnaire included questions about the diagnostic advantages of radiological breast imaging methods, the age of onset of breast cancer screening in different risk groups, and the national breast cancer screening program. The questionnaire, prepared through Google forms, was announced on social media channels used by family physicians and kept open for three months. Results: The mean age of 151 physicians was 30.4±4.3. 61.6% of the physicians were female and 38.4% were male. Only 11.9% (n=18) of the participants had previously attended a training/course on mammography. The mean correct answer score was 4.58±1.50 for 9 questions. The test scores of the residents who received specialized training in the education and research hospital were statistically significantly higher than those who received training in the university hospital (4.77±1.86 and 3.64±1.63). The mean score of residents who received previous mammography education was significantly higher than others. Conclusion: Awareness and knowledge levels of family medicine residents about breast cancer screening methods and programs should be increased with multidisciplinary training programs. Keywords: mammography, breast cancer, screening, family practice

ACR BI-RADS Breast Density and its correlation with breast cancer screening program

Background Breast cancer remains one of the leading causes of death in women over the age of 40 years. Breast cancer screening is used to identify women with asymptomatic cancer with the goal of enabling women to undergo less invasive treatments that lead to better outcomes, ideally at earlier stages and before the cancer progresses. Mammography is the best-studied breast cancer screening modality and the only recommended imaging tool for screening the general population of women. Objective to correlate the relation between ACR density of breast and breast cancer in screening program. Patients and Methods Our study included 40 women of breast cancer were depicted radiologically and histo-pathologically diagnosed after outreaching for screening by Digital Mammography by the Egyptian National Breast Cancer Screening Program in Ain Shams University Hospitals at period from January 2018 to October 2019.Their data were collected from the medical records of the program. Their age ranged between 40 and 65 years. Results According to the BI-RADS 5th edition 2013, cases were classified into four classes as follows: 6 were ACR-A (15.0%), 21 were ACR-B (52.5%), 12 were ACR-C (30.0%) and 1 were ACR-D (2.5%), So according to our study results dense breast shouldn’t be considered as a risk factor for breast cancer as we observed that the percentage of breast cancer in our study increases the most with average breast density ACR class B then increases with ACR class C and A respectively. Conclusion dense breast is not a risk factor for breast cancer, so further researches are needed to study the relationship between breast density and breast cancer in Egyptian population, to elucidate the role of breast density estimation in prediction of breast cancer considering the genotypical and phenotypical differences of the Egyptian population.

Performance Indicators of Breast Cancer Screening program Based on National Screening Guideline in Rural area of Rudsar City in Gilan Province, Iran.

Background: According to the World Health Organization (WHO), the high prevalence of breast cancer mortality in the least developed countries is due to the diagnosis at late phases. Accordingly, cost-effective breast cancer screening plans are the most effective methods to control this cancer and increase women’s survival. Methods: This study aimed to evaluate the performance of the breast cancer screening program based on the guidelines of the Iran Ministry of Health on 14,493 eligible women in rural areas of Rudsar city in 2018-19. We calculated performance indicators such as target coverage, identification of the at-risk population, early diagnosis, referral index, and other statistical using SPSS 22 software. Results: Out of 14493 rural women aged 30-59 referred to health homes, 6992 women underwent breast cancer screening. Coverage of the program in the The target population coverage was estimated at 48%. Most high-risk cases were 46 years and older, and the lowest rate was in women of <35 years. We found Thethat results showed that 0.4% of the cases patients (n=27) were identified as the high-risk, and all (100%) referred to group according to the national guidelines with referral to a specialist for further evaluation. of 100%. All patients cases identified as high-risk groups atin the first phase of screening were found with BIRADS (Breast Imaging Reporting and Data System) 4 and 5 based on biopsy specimens. Conclusion: The low target population coverage and the cases with advanced breast cancer indicated the need for more attention and consideration in implementing programs and policies for preventable cancer by all organizations. In this regard, there is a need for relevant interventions and follow-up by health authorities.