Outcome of Breast Cancer Screening: A Lebanese Single Institution Experience

Background: Since 2002, from October till December of each year, the Lebanese Ministry of Public Healthconducts a mammogram based breast cancer screening campaign in the whole country for women over 40years of age. These mammograms are performed free of charge in governmental hospitals or for reduced feesin private hospitals. The aim of this study is to analyze the direct impact of this campaign on cancer detectionand subsequent treatment. Materials and Methods: Radiologic records of women screened with a mammogramduring the campaign period from October till December 2012 at Saint Joseph Hospital, Baouchrieh, Beirut, werereviewed. Results of mammograms were reported using the ACR score. Women with ACR score ≥4 were trackedand investigated. Results: 900 screening mammograms were performed; median age was 55.2 years (range:31-81years). Some 826 (91.8%) had an ACR score of ≤2; 66 (7.3%) an ACR =3 and only 8 (0.89%) an ACR=4. Thus,less than 1% (8/900) of all screened women were considered at high risk and needed a close follow-up. Amongthese 8 women, 4 underwent surgery for an early breast cancer, one had synchronous metastatic breast cancerand two were lost to follow-up. Conclusions: To coclude, Among 900-screened women for BC, less than 1 % (8out of 900) were at high risk of hiding a BC (ACR=4), half of them benefited from early therapy (4 women outof 900) and one was a false positive. Larger studies on national level should be accomplished to have a completedata on breast cancer screening in Lebanon. The results of these studies can affect the Lebanese health policyregarding BC.     

Breast Cancer Screening in Malaysia: A Policy Review

Background: Breast cancer is the leading cause of cancer among Malaysian women. The implementation of prevention measures including screening has the potential to reduce the burden of breast cancer which caused by late presentation. Aims: This paper aimed to review the public health policy relating to breast cancer screening in Malaysia that was undertaken in order to contribute to policy development regarding cancer prevention, detection and the improvement of services for Malaysian women. Methods: The policy review strategy included a specific search of the website of the Ministry of Health in Malaysia for relevant policies. In addition, we searched Google and Pubmed for breast cancer screening programmes, policies, and guidelines for women in Malaysia. In addition, experts and stakeholders provided additional resources, published in Malay language. Relevant guidelines in the Malay language were translated into English and included the document review. Results: The policy analysis indicated that although it is known that screening, early detection and diagnosis improve survival rates, delayed diagnosis remains a significant issue.  The Ministry of Health policy stipulates the provision of opportunistic mammography screening. However, the uptake is varied, and implementation is challenging due to a lack of awareness about screening and difficulties related to accessing services, especially in rural areas. The establishment and implementation of referral guidelines is essential to receive timely treatment for breast cancer patients. There is a need to enhance the cancer reporting by the doctors to the national cancer registry, in collaboration with government services and the private cancer-care sector to improve the monitoring and evaluation of cancer control policies and programmes. Conclusion: A focus on raising awareness, increasing the accessibility of screening facilities and improving referral processes and the overall connectivity of the cancer care system are key steps to down-staging breast cancer in Malaysia.     

Using Google Trends Data to Study Public Interest in Breast Cancer Screening in Malaysia

Objective: This study aims to investigate the public pattern in seeking breast cancer screening information inMalaysia using Google Trends. Methods: The Google Trends database was evaluated for the relative Internet searchpopularity of breast cancer and screening-related search terms from 2007 to 2018. Results: Result showed downwardtrends in breast cancer search, whereas mammogram and tomosynthesis search fluctuated consistently. A significantincrement was found during Pink October month. Breast cancer search term achieved the highest popularity in the eastcoast of Malaysia with [x2 (5, N=661) = 110.93, P<0.05], whereas mammogram attained the highest search volume incentral Malaysia [x2 (4, N=67) = 18.90, P<0.05]. The cross-correlation for breast cancer was moderate among northernMalaysia, Sabah, and Sarawak (0.3 ≤ rs ≤ 0.7). Conclusion: Public interest trend in breast cancer screening is stronglycorrelated with the breast cancer awareness campaign, Pink October. Breast cancer screening should be promoted inthe rural areas in Malaysia.     

Analysis of Predictors of Breast Cancer Screening among Japanese Women using Nationally Representative Survey Data, 2001–2013

Objective: Predictors of participation in breast cancer screening in recent years or the trend of participation rate by predictors over the years has not been investigated in Japan. In this study, we investigated predictors for participation in breast cancer screening and analyzed the trend of participation rate depending on the predictors using nationally representative survey data in Japan. Methods: The data of “Comprehensive Survey of Living Conditions” in Japan from 2001 to 2013 were used. Participation in breast cancer screening was used as an outcome. Next, as explanatory variables, we used age group, marital status, living arrangements, educational level, household income, employment status, smoking status, regular outpatient visit status, and self-rated health status. Then, the participation rate for breast cancer screening was calculated for each of the factors over the years. In addition, multivariate logistic regression analysis was conducted to analyze the association between each factor and the participation rate using data from 2010 and 2013. Results: We found that non-married women, women with lower educational level, women with low household income, self-employed or unemployed women, smokers, and women with low self-rated health status were significantly less likely to participate in breast cancer screening. Conversely, the participation rate increased for all predictor groups from 2001 to 2013, and the increase in the participation rate for never-married women was particularly evident compared with the other marital statuses. However, significant differences in the participation rate for breast cancer screening existed depending on marital status, household income, employment status, and smoking status throughout the analyzed years. Conclusion: Our findings suggest that further recommendations for breast cancer screening are particularly needed among women of low socioeconomic status and those who are self-employed or unemployed to increase the participation rate in Japan.     

Misinformation and Facts about Breast Cancer Screening

Quality medical practice is based on science and evidence. For over a half-century, the efficacy of breast cancer screening has been challenged, particularly for women aged 40–49. As each false claim has been raised, it has been addressed and refuted based on science and evidence. Nevertheless, misinformation continues to be promoted, resulting in confusion for women and their physicians. Early detection has been proven to save lives for women aged 40–74 in randomized controlled trials of mammography screening. Observational studies, failure analyses, and incidence of death studies have provided evidence that there is a major benefit when screening is introduced to the general population. In large part due to screening, there has been an over 40% decline in deaths from breast cancer since 1990. Nevertheless, misinformation about screening continues to be promoted, adding to the confusion. Despite claims to the contrary, a careful reading of the guidelines issued by major groups such as the U.S. Preventive Services Task Force and the American College of Physicians shows that they all agree that most lives are saved by screening starting at the age of 40. There is no scientific support for using the age of 50 as a threshold for screening. All women should be provided with the facts and not false information about breast cancer screening so that they can make “informed decisions” for themselves about whether to participate.     

Knowledge,Barriers and Attitudes Towards Breast Cancer Mammography Screening in Jordan

Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused onannual campaigns aimed at increasing awareness about breast cancer and encouraging women to conductmammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is aneed to evaluate current mammography screening uptake and its predictors, assess women’s knowledge andattitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service.Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through faceto-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants withmean age of 46.8±7.8 years were interviewed. There was low participation rate in early detection of breastcancer practices. Breast self-examination, doctor examination and periodic mammography screening werereported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breastcancer screening at least once but not periodically, while 87.6% had never undergone mammography screening.Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer(23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents haveshown higher probability of undergoing mammogram than those who live in towns or villages. Results revealednegative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening.The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%);no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa WaQadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, theuptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regularsystematic mammography screening for breast cancer. Additionally, there is a need for improvement in thecurrent health promotion programmes targeting breast cancer screening. Other areas that could be targeted infuture initiatives in this field include access to screening in rural areas and removal of current barriers.     

Women's Breast Cancer Risk Perception and Attitudes Toward Screening Tests

This study's objective is to identify women's breast cancer risk perceptions and their attitudes and knowledge on screening tests. The cross-sectional research. Gulhane Military Medical Academy, Ankara, Turkey. The population of 188 females who applied for gynecological examination. The study employed a semistructured questionnaire form. Questions such as female's demographic data, attitudes based on screening tests of breast cancer, family history, perceived risk breast cancer, and questions with regard to patients’ fear of breast cancer were included in the survey. In this study, it is determined that the rates of the women, who conduct breast self-examination (BSE), clinical breast examination (CBE) and mammography at least once, are very low. The reason for not performing the BSE was declared with a rate of 50.8% as “Do not know how to perform.” Of the women 20.2% were fully acknowledged about BSE. Nearly half of the women perceived 50% or more risk of developing breast cancer, and this rate increases as they get older. The risk perception and educational status increased CBE and mammography rates and BSE knowledge positively, but because of insufficient BSE application abilities BSE rate cannot increase as expected. It is recommended that nurses put forward the initiatives in training programs to increase women's BSE abilities. In planning such an education program risk perception and information of women about breast cancer should be considered.     

An Effective Two Way Classification of Breast Cancer Images: A Detailed Review

Cancer, a disease of cells, causes cell growth which differs from normal cell growth ratio, this cell growth spreadsin the human body and kills the body cells. Breast cancer, it’s a highly heterogeneous disease and western womencommonly witness this. Mammography, a pre-screening X-ray based check is used to diagnose woman’s breast cancer.This basic test mode helps in identifying breast cancer at early stage and this early stage detection would support inrecovering more number of women from this serious disease. Medical centres deputed highly skilled radiologists andthey were given the responsibility of analysing this mammography results but still human errors are inevitable. An errorfrequency ratio is high when radiologists exhausted in their analysis task and leads variations in either observationsie., internal or external observation. Also, quality of the image plays vital role in Mammographic sensitivity and leadsto variation. Several automation processes were tried in streamlining and standardising diagnosis analysis process andquality of breast cancer images were improved. This paper inducts a two way mode algorithm for grouping of breastcancer images to 1. benign (tumour growing, but not dangerous) and 2. malignant (cannot be controlled, it causes death)classes. Two-way mode data mining algorithms are used due to thinly dispersed distribution of abnormal mammograms.First type algorithm is k-means algorithm, which regroups the given data elements into clusters (ie., prioritized by theusers). Second type algorithm is Support Vector Machine (SVM), which is used to identify the most suitable functionwhich differentiates the members based on the training data.     

Factors Influencing Breast Cancer Screening Behavior among Iranian Women

Background: Early detection of breast cancer is of great importance to improve women’s health and to decreasethe cost related to cancer death. Therefore, recognition of variables related to breast cancer screening behaviorsis necessary. Objectives of this study were to identify the rates of breast self-examination (BSE) performance andmammography use in Iranian women, and to characterize the demographic and cognitive factors associated withtheir breast cancer screening behavior. Method: Data were collected from a convenience sample of 388 females,using an adapted version of Champion’s revised Health Belief Model Scale. Results: The results showed that7.5% of the participants performed BSE on a regular monthly basis, and among the women aged 40 and older,14.3% reported having had at least one mammography in their lifetime. Perceived self-efficacy and perceivedbarriers to BSE were significant predictors for BSE performance. For having mammography, health motivationwas the main predictor. Conclusion: Eliminating barriers and increasing perceived self-efficacy with an emphasisto make the women acquainted with BSE performance; as well as increasing health motivation of women andpersuading of physicians for clinical breast examination (CBE) performance with low cost and free access tom ammography, are important to promote BSE and mammography.     

Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review

Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs.     

Awareness of Breast Cancer among Surgical Patients in a Tertiary Hospital in Malaysia

Background: Breast cancer is the commonest cancer among women worldwide. About one in nineteen women in Malaysia are at risk, compared to one in eight in Europe and the United States. The objectives of this study were: (1) to assess patients’ knowledge on risk factors, symptoms and methods of screening of breast cancer; and (2) to determine their perceptions towards the disease treatment outcomes. Methods: A cross-sectional survey using a validated self-administered questionnaire was conducted among 119 consecutive surgical female patients admitted from 1st of September to 8th of October 2015 in Hospital Sultan Abdul Halim, Kedah. Data were analyzed using General linear regression and Spearman’s correlation with Statistical Package for Social Science (SPSS) version 20. Results: Mean (SD) age was 40.6 (15.1) years and majority of the patients were Malay (106, 89.1%). Mean scores for general knowledge, risk factors and symptoms of breast cancer were 50.2 (24.0%), 43.0 (22.9%) and 64.4 (28.4%) respectively. Mean total knowledge score was 52.1(19.7%). 80 (67.2%) and 55 (46.2%) patients were aware of breast self-examination and clinical breast examination recommendations, respectively. Generally, patients had positive perceptions towards breast cancer treatment outcomes. However, majority (59.7%) considered that it would be a long and painful process. Knowledge was significantly better among married women with spouses (p=0.046), those with personal history of breast cancer (p=0.022) and with monthly personal income (p=0.001) with the coefficient of determination, R2=0.16. Spearman’s correlation test showed a significant positive relationship between monthly personal income and breast cancer awareness (r = 0.343, p <0.001). Conclusion: Awareness on breast cancer among our patients was average. Thus, there is a need for more awareness programs to educate women about breast cancer and promote its early detection.     

Type of Breast Cancer Diagnosis,Screening, and Survival

IntroductionBreast cancer screening is known to reduce mortality. In the present study, we analyzed the prevalence of breast cancers detected through screening, before and after introduction of an organized screening, and we evaluated the overall survival of these patients in comparison with women with an extrascreening imaging-detected breast cancer or those with palpable breast cancers.Materials and MethodsWe collected data about all women who underwent a breast operation for cancer in our department between 2001 and 2008, focusing on type of tumor diagnosis, tumor characteristics, therapies administered, and patient outcome in terms of overall survival, and recurrences. Data was analyzed by R (version 2.15.2), and P < .05 was considered significant.ResultsAmong the 2070 cases of invasive breast cancer we considered, 157 were detected by regional mammographic screening (group A), 843 by extrascreening breast imaging (group B: 507 by mammography and 336 by ultrasound), and 1070 by extrascreening breast objective examination (group C). The 5-year overall survival in groups A, B, and C were, respectively, 99% (95% CI, 98%-100%), 98% (95% CI, 97%-99%), and 91% (95% CI, 90%-93%), with a significant difference between the first 2 groups and the third (P < .05) and a trend between groups A and B (P = .081).ConclusionThe diagnosis of invasive breast cancer with screening in our population resulted in a survival gain at 5 years from the diagnosis, but a longer follow-up is necessary to confirm this data.     

Epidemiology of Breast Cancer in Malaysia

Data from the National Cancer Registry of Malaysia for 2004 provide an age-standardised incidence rate (ASR)of 46.2 per 100,000 women. This means that approximately 1 in 20 women in the country develop breast cancer intheir lifetime. However, the rate differs between the three main races, the Malays, Chinese and Indians. The agestandardized incidence in Chinese is the highest, with 59.7 per 100,000, followed by the Indians at 55.8 per 100,000.The Malays have the lowest incidence of 33.9 per 100,000. This translates into 1 in 16 Chinese, 1 in 16 Indian and 1in 28 Malay women developing breast cancer at some stage in their lives. The commonest age at presentation isbetween 40-49 years, with just over 50% of the cases under the age of 50 years, 16.8% below 40, and 2% under 30.Some 55.7% of all cases were found to be ER positive. The commonest presenting symptom was a lump in the breastin over 90% of cases, generally felt by the woman herself. The mean size of the lump was 4.2 cm, and on average, thewomen waited 3 months before seeking medical attention. Over the 12-year period from 1993 to 2004, about 60-70%of women presented with early stage (Stages 1- 2) while 30-40% presented with late breast cancer (Stages 3-4).Especially Malays present at later stages and with larger tumours. Consequently their survival is worse than withChinese and Indian women. The challenge in Malaysia is to be able to provide a comprehensive service in the diagnosisand treatment of breast cancer, and this requires training of a team of health professionals dedicated to breasthealth, such as breast surgeons, radiologists specializing in breast imaging, breast pathologists, plastic surgeonsspecializing in breast reconstruction, medical and radiation oncologists, psycho-oncologists, counselors, and breastnurses. Advocacy can play a role here in galvanizing the political will to meet this challenge.     

Influence of Mammographic Screening on Breast Cancer Incidence Trends in South Australia

Purpose: To examine breast cancer (BC) incidence trends in relation to mammographic screening and riskfactor prevalence in South Australia (SA). Materials and Methods:Trends in annual BC incidence rates werecalculated using direct standardisation and compared with projected incidence derived from Poisson regressionanalysis of pre-screening rates. Annual percentage change and change time points were estimated using Joinpointsoftware. Biennial mammography screening participation rates were calculated using data from BreastScreenSA. Trends in overweight/obesity, alcohol use and hormone replacement therapy (HRT) use were examined using1991-2009 Health Omnibus Survey data. Trends in total fertility were examined using data from the AustralianBureau of Statistics. Results: BC incidence increased around the time BreastScreen commenced and thenstabilised in the mid-1990s. However rates have remained higher than projected, even though the proportionand age distribution of first time screening attendees stabilised around 1998. A decrease in BC incidence wasobserved among women aged 50-59yrs from the late-1990’s but not among older women. Obesity and alcoholuse have increased steadily in all age groups, while HRT use declined sharply from the late-1990s. Conclusions:BC incidence has remained higher than projected since mammography screening began. The sustained elevationis likely to be due to lead time effects, though over-diagnosis cannot be excluded. Declining HRT use has alsoimpacted incidence trends. Implications: Studies using individual level data, which can account for changes inrisk factor prevalence and lead time effects, are required to evaluate ‘over-diagnosis’ due to screening.     

Screening in the Era of Economic Crisis: Misperceptions and Misuse from a Longitudinal Study on Greek Women Undergoing Benign Vacuum-assisted Breast Biopsy

Background: To evaluate knowledge about screening tests and tests without proven screening value in a GreekBreast Unit population undergoing benign vacuum-assisted breast biopsy (VABB). Materials and Methods: Thisstudy included 81 patients. Three knowledge-oriented items (recommended or not, screening frequency, age ofonset) were assessed. Regarding screening tests two levels of knowledge were evaluated: i). crude knowledge(CK), i.e. knowledge that the test is recommended and ii). advanced knowledge (AK), i.e. correct response toall three knowledge-oriented items. Solely CK was evaluated for tests without proven screening value. Riskfactors for lack of knowledge were assessed with multivariate logistic regression. A second questionnaire wasadministered 18 months after VABB to assess its impact on the performance of tests. Results: Concerningscreening tests considerable lack of AK was noted (mammogram, 60.5%; Pap smear, 59.3%; fecal occult bloodtesting, 93.8%; sigmoidoscopy, 95.1%). Similarly lack of CK was documented regarding tests without provenscreening value (breast self-examination, 92.6%; breast MRI, 60.5%; abdominal ultrasound, 71.6%; bariummeal, 48.1%; urine analysis, 90.1%; chest X-Ray, 69.1%; electrocardiogram, 74.1%; cardiac ultrasound,75.3%). Risk factors for lack of AK were: place of residence (mammogram), age (Pap smear), personal income(sigmoidoscopy); risk factors for lack of CK included number of offspring (breast MRI, chest X-Ray), BMI(abdominal ultrasound), marital status (urine analysis), current smoking status (electrocardiogram). VABB’sonly effect was improvement in mammogram rates. Conclusions: A considerable lack of knowledge concerningscreening tests and misperceptions regarding those without proven value was documented.     

Predictors of Progress in the Stage of Adoption of Breast Cancer Screening for Korean Women

Background: It has been proven that an individuals health behavior is determined through a series ofprocesses. This study aimed to assess the stages of adoption of breast cancer screening, and to identify the factorsrelating to progress through these stages. Materials and Methods: There were 202 female participants aged 20-59 years who were living in Chungbuk, South Korea. They were informed of the study purpose and agreed toparticipate. Data were collected from October 2010 to January 2011 by assessing the breast cancer screeningstage, health beliefs, socio-demographic factors, and other facilitating factors. The participant current stage ofadoption of breast cancer screening was classified using the Precaution Adoption Process Model (PAPM), andthe various PAPM stages were compared with each other to identify factors likely to determine progress betweenstages. The data were analyzed using the χ2-test, ANOVA, Duncan test, and multiple logistic regression. Results:Approximately half of all participants were not on-schedule for breast self-examination and mammography(unaware, 9.4% and 11.4%, unengaged, 8.4% and 5.0%, undecided, 20.3% and 17.8%, decided not to act, 1.5%and 1.0%, decided to act, 13.4% and 15.3%, respectively). The factors likely to determine the progress fromone stage to another were age, marital status, exposure to media information about breast cancer, self-efficacy,and perceived severity. Conclusions: These results suggest that it is necessary to develop a tailored message forbreast cancer screening behavior.     

乳腺间期癌

目的 :调查 1996～ 1998年接受乳腺普查妇女的间期癌发病率 ,探讨乳腺癌普查间隔的合理时间。方法 :收集发生间期癌距离普查的时间、间期癌大小、腋淋巴结转移情况和病理诊断 ,并复习普查X线钼靶片。结果 :间期癌 2 5例 ,发病率为 0 .3‰ ,平均发病时间 (13.8± 5.9)个月。肿瘤最大径≤ 1.0cm者 1例 ,1.1～ 3.0cm 18例 ,3.1～ 5.0cm 4例 ,>5.0cm 1例 ,无肿块者 1例。临床分期 :Ⅰ期 2例 ,Ⅱ期 16例 ,Ⅲ期 7例。 7例腋淋巴结转移。病理类型均为浸润性癌。结论 :本文间期癌发病率低于国外资料报告 ,说明普查有效。 80 %的间期癌发生在 50岁以下的妇女。对 4 0岁以下妇女 ,若存在乳腺癌高危因素 ,普查间期宜改为每年 1次 ,可明显降低间期癌发病率。     

Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment

Breast tissue density (BTD) is known to increase the risk of breast cancer but is not routinely used in the risk assessment of the population-based High-Risk Ontario Breast Screening Program (HROBSP). This prospective, IRB-approved study assessed the feasibility and impact of incorporating breast tissue density (BTD) into the risk assessment of women referred to HROBSP who were not genetic mutation carriers. All consecutive women aged 40–69 years who met criteria for HROBSP assessment and referred to Genetics from 1 December 2020 to 31 July 2021 had their lifetime risk calculated with and without BTD using Tyrer-Cuzick model version 8 (IBISv8) to gauge overall impact. McNemar’s test was performed to compare eligibility with and without density. 140 women were referred, and 1 was excluded (BRCA gene mutation carrier and automatically eligible). Eight of 139 (5.8%) never had a mammogram, while 17/131 (13%) did not have BTD reported on their mammogram and required radiologist review. Of 131 patients, 22 (16.8%) were clinically impacted by incorporation of BTD: 9/131 (6.9%) became eligible for HROBSP, while 13/131 (9.9%) became ineligible (p = 0.394). It was feasible for the Genetics clinic to incorporate BTD for better risk stratification of eligible women. This did not significantly impact the number of eligible women while optimizing the use of high-risk supplemental MRI screening.     

Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study

Background: Breast cancer remains the leading cause of death for women globally, including in Indonesia. Breast cancer screening plays a vital role in reducing deaths caused by breast cancer. However, breast cancer screening rate is still low and studies on determinants for breast cancer screening is limited in Indonesia. This study aimed to identify the determinants of breast cancer screening among women in Indonesia. Methods: This population-based study was conducted among 827 women who lived in either rural and urban areas, using a stratified sampling design where were based on province and locality combinations. Data were analysed using a binary logistic regression model to assess the associations between independent and dependent variables. Results: As many as 827 women with an average age of 29.91 (± 11.14) years old participated in this study. The overall breast cancer screening among women was 18.74%. Knowledge of breast cancer risk factors, signs, and symptoms (adj.OR = 1.75, 95%CI: 1.20 – 2.56), age of 35 to 39 years old (adj.OR. = 1.52, 95% CI: 1.02 – 2.26), and household income of ≥6,000,000 IDR (≥457 USD) (adj.OR. = 5.19, 95%CI: 1.43–18.84) were associated with breast cancer screening attendance. In contrast, Christian women had a significantly lower breast cancer screening rate that women from other religions (adj. OR. = 0.45, 95%CI: 0.24 – 0.85). Conclusion: The overall breast cancer screening attendance was poor among Indonesian women population. Age, household income, religion, and knowledge of breast cancer risk factors were identified as the determinant factors for breast cancer screening.