Selective screening of breast cancer in women at increased risk: A pilot study.
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25 November 2022
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Background: Female Breast Cancer (FBC) ranks first as regards to incidence and mortality worldwide. In Mauritius, this is also the case with an ASR(W) of 58.2/105 for 2014. Early detection through early diagnosis and/or screening are two ways of combatting the disease. In Mauritius, no systematic screening program is currently available, though Clinical Breast Examination (CBE) activities are encouraged as part of Non-Communicable Disease (NCD) programmes. A pilot study for high risk FBC screening by mammography has been conducted in 2015. Methods: Women recently diagnosed with breast cancer below the age of 40 throughout the island were identified and their eligible first degree relatives were invited to participate in our program. The women underwent clinical breast examination as well as imaging tests in a Breast Risk Assessment Clinic to evaluate their breast cancer status. Results: Our 5 month study allowed invitation of 109 first degree relatives out of whom 52 attended the program. This response rate of 48% was due to different reasons including fear, lack of motivation and/or misconceptions regarding breast cancer screening. No sign of malignancy was detected among the 52 participants although signs of benign breast conditions were present in one out of ten women. Most of the participants felt reassured about breast cancer after their participation although some degree of anxiety was experienced during the course of the program. Conclusions: A selective screening program appears preferable to a population based screening program in the Mauritian set up. Promotion of early diagnosis of breast cancer through clinical breast examination and teaching of breast self-examination is also necessary. We hope that the setting up of a selective screening program increases awareness regarding breast cancer and its early signs. Future investigations like BRCA1/2 are to be forecasted for familial hereditary breast cancer, as Mauritius is a small island. Moreover, a gradual destigmatisation of cancer has been noticed in Mauritius, with at least 50% of patients discussing their disease with their families, which breaks the taboo.
Keywords
Breast cancer,Mauritius,high risk FBC screening,mammography,pilot study
