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Making breast screening more accessible

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Dr. Jenny Edge, a surgical specialist at the Faculty of Medicine and Health Sciences and Tygerberg Hospital, revealed that only 8% of breast cancer cases are diagnosed early (stage 1) at state clinics in South Africa, with the majority of patients (60%) already in advanced stages of cancer at the time of diagnosis. Advanced cancer is typically harder to treat, underscoring the importance of early detection. While there are various screening methods available, such as mammography and MRI, they require trained health professionals and can be costly, leading many women to forego regular screening until symptoms appear. In fact, over 90% of breast cancer patients in state clinics present with a palpable breast mass.

To address this issue, a team of researchers led by Dr. David Gorry, a surgical registrar at the Faculty of Medicine and Health Sciences and Tygerberg Hospital, developed a Risk Stratified Breast Screening project that utilizes the International Breast Cancer Interventions Study tool (IBIS). This algorithm calculates a woman's risk of developing breast cancer within 10 years of her current age, and if her risk is estimated to be greater than 1%, she is referred for clinical examination or mammography. The IBIS tool has the potential to screen large populations of women, quickly assess individual risk, and identify those who require further examination.

The researchers conducted a feasibility study of the IBIS tool by inviting over 2,000 nurses at Tygerberg Hospital to undergo breast cancer screening. The study showed that nurses who had regular exposure to breast cancer patients were more likely to participate in screening. While the study taught the researchers many valuable lessons, the use of risk stratification in a clinical breast screening program was deemed workable and is expected to be published in a scientific journal soon.

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