Early Diagnosis of Breast Cancer in the Absence of Population-Based Mammographic Screening in Asia

Abstract

Asia is made up of mainly low- and middle-income countries, where the majority of breast cancer presents as late-stage disease where survival is poor even with treatment. We review methods of early diagnosis of breast cancer in countries where population-based mammographic screening is not feasible. While there is insufficient evidence that breast self-examination and clinical breast examination (CBE) lead to a reduction in breast cancer mortality, recent trials have shown that screening with CBE successfully reduces stage at diagnosis, which may translate to improved breast cancer survival with longer follow-up. CBE may have an educational component whereby women with new breast lumps may seek care earlier. Overcoming sociocultural barriers to early detection in Asia is important before any early detection programme can be implemented. Public education, together with strengthening existing public health services, is key to earlier diagnosis of breast cancer.