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Results of a pilot programme of mammographic breast cancer screening in the Western Cape

Justus P Apffelstaedt, Retha Hattingh, Karin Baatjes, Natalie Wessels

Abstract


Background. Mammographic screening programmes are now established in developing countries. We present an analysis of the first screening programme in sub-Saharan Africa.

Methods. Women aged ≥40 years were identified at three primary healthcare centres in the Western Cape Province, South Africa, and after giving informed consent underwent mammography at a mobile unit. After a single reading, patients with American College of Radiology Breast Imaging Reporting and Data System (BIRADS) 3 - 5 lesions were referred to a tertiary centre for further management.

Results. Between 1 February 2011 and 31 August 2012, 2 712 screening mammograms were performed. A total of 261 screening mammograms were reported as BIRADS 3 - 5 (recall rate 9.6%). Upon review of the 250 available screening mammograms, 58 (23%) were rated benign or no abnormalities (BIRADS 1 and 2) and no further action was taken. In 32 women, tissue was acquired (biopsy rate for the series 1.2%); 10 cancers were diagnosed (biopsy malignancy rate 31%). For the entire series of 2 712 screening mammograms, the cancer diagnosis rate was 3.7/1 000 examinations. Of 10 cancers diagnosed at screening, 5 were TNM clinical stage 0, 2 stage I and 3 stage II.

Conclusions. The low cancer detection rate achieved, and the technical and multiple administrative problems experienced do not justify installation of a screening programme using the model utilised in this series. 


Authors' affiliations

Justus P Apffelstaedt, Department of Surgery, Faculty of Medicine and Health Sciences, Tygerberg Hospital; Stellenbosch University, Tygerberg, South Africa

Retha Hattingh, Department of Radiology, Tygerberg Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa

Karin Baatjes, Department of Surgery, Faculty of Medicine and Health Sciences, Tygerberg Hospital; Stellenbosch University, Tygerberg, South Africa

Natalie Wessels, Department of Surgery, Faculty of Medicine and Health Sciences, Tygerberg Hospital; Stellenbosch University, Tygerberg, South Africa

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Keywords

Breast cancer; mammography; breast screening

Cite this article

South African Medical Journal 2014;104(4):297-298. DOI:10.7196/SAMJ.7242

Article History

Date submitted: 2013-07-07
Date published: 2014-01-20

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