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Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden

BACKGROUND: Breast cancer (BC) is the most frequently diagnosed cancer and leading cause of cancer deaths among women in low‐income countries. Ethiopia does not have a national BC screening program, and over 80% of patients are diagnosed with advanced stage disease. The aim of this study was to asse...

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Autores principales: Ayele, Wondimu, Addissie, Adamu, Wienke, Andreas, Unverzagt, Susanne, Jemal, Ahmedin, Taylor, Lesley, Kantelhardt, Eva J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176994/
https://www.ncbi.nlm.nih.gov/pubmed/33650727
http://dx.doi.org/10.1002/onco.13737
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author Ayele, Wondimu
Addissie, Adamu
Wienke, Andreas
Unverzagt, Susanne
Jemal, Ahmedin
Taylor, Lesley
Kantelhardt, Eva J.
author_facet Ayele, Wondimu
Addissie, Adamu
Wienke, Andreas
Unverzagt, Susanne
Jemal, Ahmedin
Taylor, Lesley
Kantelhardt, Eva J.
author_sort Ayele, Wondimu
collection PubMed
description BACKGROUND: Breast cancer (BC) is the most frequently diagnosed cancer and leading cause of cancer deaths among women in low‐income countries. Ethiopia does not have a national BC screening program, and over 80% of patients are diagnosed with advanced stage disease. The aim of this study was to assess how many women self‐report a breast abnormality and to determine their diagnoses in rural Ethiopia. METHODS: A community‐based cross‐sectional study was conducted among 7,573 adult women. Women were interviewed and educated about breast awareness, and those who reported breast abnormalities underwent clinical examination by experienced surgeons. Ultrasound‐guided fine needle aspiration cytology (FNAC) was obtained, and cytological analysis was performed. The findings were projected to the female population of Ethiopia to estimate current and future burden of diseases. FINDINGS: Of the 7,573 women surveyed, 258 (3.4%) reported a breast abnormality, 246 (3.2%) received a physical examination, and 49 (0.6%) were found to be eligible for ultrasound‐guided FNAC or nipple discharge evaluation. Of all the cases, five (10.2%) breast malignancies were diagnosed. We projected for Ethiopia that, approximately, 1 million women could self‐report a breast abnormality, 200,000 women could have a palpable breast mass, and 28,000 women could have BC in the country. CONCLUSION: The health care system needs to build capacity to assess and diagnose breast diseases in rural areas of Ethiopia. These data can be used for resource allocation to meet immediate health care needs and to promote detecting and treating BC at earlier stages of disease. IMPLICATIONS FOR PRACTICE: Routine mammography screening in a resource‐limited country with a young population is neither sensitive nor affordable. Clinical breast examination with consecutive ultrasound‐guided fine needle aspiration cytology may ensure early diagnosis, downstage disease, and reduce breast cancer mortality. This study had the unique opportunity to educate over 7,573 rural women about breast abnormalities and offer clinical and cytological diagnosis for reported breast abnormalities. The findings were extrapolated to show the nationwide burden of breast abnormalities and unmet diagnostic needs. These data will serve as policy guide to improve adequate referral mechanisms and breast diagnostic and treatment facilities.
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spelling pubmed-81769942021-06-15 Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden Ayele, Wondimu Addissie, Adamu Wienke, Andreas Unverzagt, Susanne Jemal, Ahmedin Taylor, Lesley Kantelhardt, Eva J. Oncologist Global Health and Cancer BACKGROUND: Breast cancer (BC) is the most frequently diagnosed cancer and leading cause of cancer deaths among women in low‐income countries. Ethiopia does not have a national BC screening program, and over 80% of patients are diagnosed with advanced stage disease. The aim of this study was to assess how many women self‐report a breast abnormality and to determine their diagnoses in rural Ethiopia. METHODS: A community‐based cross‐sectional study was conducted among 7,573 adult women. Women were interviewed and educated about breast awareness, and those who reported breast abnormalities underwent clinical examination by experienced surgeons. Ultrasound‐guided fine needle aspiration cytology (FNAC) was obtained, and cytological analysis was performed. The findings were projected to the female population of Ethiopia to estimate current and future burden of diseases. FINDINGS: Of the 7,573 women surveyed, 258 (3.4%) reported a breast abnormality, 246 (3.2%) received a physical examination, and 49 (0.6%) were found to be eligible for ultrasound‐guided FNAC or nipple discharge evaluation. Of all the cases, five (10.2%) breast malignancies were diagnosed. We projected for Ethiopia that, approximately, 1 million women could self‐report a breast abnormality, 200,000 women could have a palpable breast mass, and 28,000 women could have BC in the country. CONCLUSION: The health care system needs to build capacity to assess and diagnose breast diseases in rural areas of Ethiopia. These data can be used for resource allocation to meet immediate health care needs and to promote detecting and treating BC at earlier stages of disease. IMPLICATIONS FOR PRACTICE: Routine mammography screening in a resource‐limited country with a young population is neither sensitive nor affordable. Clinical breast examination with consecutive ultrasound‐guided fine needle aspiration cytology may ensure early diagnosis, downstage disease, and reduce breast cancer mortality. This study had the unique opportunity to educate over 7,573 rural women about breast abnormalities and offer clinical and cytological diagnosis for reported breast abnormalities. The findings were extrapolated to show the nationwide burden of breast abnormalities and unmet diagnostic needs. These data will serve as policy guide to improve adequate referral mechanisms and breast diagnostic and treatment facilities. John Wiley & Sons, Inc. 2021-03-19 2021-06 /pmc/articles/PMC8176994/ /pubmed/33650727 http://dx.doi.org/10.1002/onco.13737 Text en © 2021 The Authors. The Oncologist published by Wiley Periodicals LLC on behalf of AlphaMed Press. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Global Health and Cancer
Ayele, Wondimu
Addissie, Adamu
Wienke, Andreas
Unverzagt, Susanne
Jemal, Ahmedin
Taylor, Lesley
Kantelhardt, Eva J.
Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden
title Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden
title_full Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden
title_fullStr Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden
title_full_unstemmed Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden
title_short Breast Awareness, Self‐Reported Abnormalities, and Breast Cancer in Rural Ethiopia: A Survey of 7,573 Women and Predictions of the National Burden
title_sort breast awareness, self‐reported abnormalities, and breast cancer in rural ethiopia: a survey of 7,573 women and predictions of the national burden
topic Global Health and Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176994/
https://www.ncbi.nlm.nih.gov/pubmed/33650727
http://dx.doi.org/10.1002/onco.13737
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