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Screening and Early Diagnosis of Breast Cancer: Proven Methodology and an Optimized Strategy for Developing Countries

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Breast and Gynecological Cancers

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Abstract

Breast cancer is emerging as a major health care challenge in developing countries. Most recent data show that breast cancer is the most frequently diagnosed cancer in women and the leading cause of mortality from cancer. Breast cancer incidence in developing countries accounts for 51 % of the worldwide incidence. Younger women, i.e., between the ages of 15 and 49, are diagnosed with breast cancer in developing countries in a higher proportion than in developed countries (23 % to 10 %). Cost-effective health care interventions are urgently needed to reduce the increasing mortality rate from breast cancer. This chapter provides an overview of methods that have been extensively studied and whose benefits have been validated to screen for breast cancer in developed countries. Screening mammography is discussed in detail, and its benefits and potential harms are presented with an outline of the challenges of implementation and extensive resources that an organized or an opportunistic program involves. Potential low cost alternatives that may be more relevant in low resource settings such as clinical breast examination (CBE) and breast self-examination are presented. Finally, an optimal strategy for screening for breast cancer is described. This involves improved awareness of breast health among women through education and self-awareness, and periodic screening CBE performed by a trained health care professional combined with a focused sonographic evaluation of screen positive women. A detailed discussion of the use of ultrasound in characterizing palpable abnormalities in the breast and its role in optimally triaging patients who need diagnostic tissue sampling, thereby minimizing false positives, is presented. Finally, the pros and cons of fine needle aspiration biopsy and large core needle biopsy in the assessment of palpable solid masses that need tissue diagnosis are discussed.

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  1. Woman’s Center for Breast Care and MRI, Woman’s Hospital of Texas, Houston, TX, 77054, USA

    Mahesh K. Shetty

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    Mahesh K. Shetty

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Shetty, M.K. (2013). Screening and Early Diagnosis of Breast Cancer: Proven Methodology and an Optimized Strategy for Developing Countries. In: Shetty, M. (eds) Breast and Gynecological Cancers. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1876-4_4

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