Analysing the Insights and Assessing the Impact of a Digital Mammography and Tomosynthesis Based 2-year Long Prospective Breast Screening Programme Organised in Western India

BACKGROUND: While the past decades have seen a rise in the number of cases diagnosed with cancer, breast cancer in particular has become the most frequently diagnosed cancer in women over the past decade. The figures for associated mortality are on a decline in most Western and developed nations, but in contrast they continue to remain high in transitional nations like India. MATERIALS AND METHODS: After receiving approval by IEC and IRB, we set-up a prospective 2-year long screening programme combined with outreach camps to ensure representation of the larger population and include urban, rural and tribal population. Strict screening criteria were enforced and trained female paramedical staff were assigned to the camp for patient counselling and breast cancer awareness. Investigation was performed at the tertiary care institute utilising both full-field digital breast mammography and tomosynthesis. Biopsy was advised for highly suspicious lesions. RESULTS: The study encompassed n=1017 Indian women and revealed that 39% (n=397) of them belonged to 41-50 years age group. BIRADS categorisation of the lesions revealed that while majority (57%; n=580) women had no detectable abnormality, nearly 22% (n=224) had lesions suspected to be benign while 10% (n=99) of them had lesions with a suspicion of high index of malignancy. 43% (n=437) of the populace had dense breasts (type-C). Most of the BIRADS-5 lesions (36/38) were confirmed as malignant on histopathology. CONCLUSION: We propose a model for screening mammography and also presents the results of this programme which we implemented to screen populace from a large and densely populated geographic region. The model was successful in being self-sustainable and received a good turnout on the back of community outreach breast awareness camps and by incentivizing the women by performing mammograms completely free of cost and also providing them reports.