ArticlePloS one2018
Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Breast cancer screening in sub-Saharan Africa: a systematic review and ethical appraisal.BMC cancer · 2022Pooled it
- Prior Cervical Cancer Screening, Social Determinants of Health, and HIV Status Among Patients at the Cancer Disease Hospital, Zambia.Research square · 2026Article
- Integrating Human Papillomavirus and HIV Services Into a One-Stop Breast Cancer Early Detection Clinic in Zambia.JCO global oncology · 2026Article
- Breast cancer in Zimbabwe: patterns of care and correlates of adherence in a national referral hospital radiotherapy center cohort from 2014 to 2018.Cancer medicine · 2021Article
- Cancer Screening in the Coronavirus Pandemic Era: Adjusting to a New Situation.JCO global oncology · 2021Article
- Establishing women's cancer care services in a fragile, conflict and violence affected ecosystem in Africa.Ecancermedicalscience · 2021Article
- Leveraging a matrix of stakeholders to facilitate access to chemotherapy for women's cancers in the Democratic Republic of the Congo.Ecancermedicalscience · 2021Article
- Building a breast cancer detection and treatment platform in the Democratic Republic of the Congo by integrating training, service and infrastructure development.Ecancermedicalscience · 2021Article
- Minimizing Delays in the Breast Cancer Pathway by Integrating Breast Specialty Care Services at the Primary Health Care Level in Zambia.JCO global oncology · 2020Article
- Clinical Utility of a Hand-Held Scanner for Breast Cancer Early Detection and Patient Triage.JCO global oncology · 2020Article
- Challenges, Opportunities, and Priorities for Advancing Breast Cancer Control in Zambia: A Consultative Meeting on Breast Cancer Control.Journal of global oncology · 2019Article
- DELAYED REFERRAL FOR DIAGNOSTIC ENDOSCOPY IS A CONTRIBUTING FACTOR TO LATE GASTRIC CANCER DIAGNOSIS IN ZAMBIA.The health press · 2019Article
- Knowledge and Health Seeking Behaviour of Breast Cancer Patients in Ghana.International journal of breast cancer · 2019Article
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Authors and funding
12 authors.
Funding
Abstract
backgroundLong delays to diagnosis is a major cause of late presentation of breast diseases in sub-Saharan Africa.
aimsWe designed and implemented a single-visit breast care algorithm that overcomes health system-related barriers to timely diagnosis of breast diseases.
methodsA multidisciplinary team of Zambian healthcare experts trained a team of mid- and high-level Zambian healthcare practitioners how to evaluate women for breast diseases, and train trainers to do likewise. Working collaboratively, the two teams then designed a clinical platform that provides multiple breast care services within a single visit. The service platform was implemented using a breast outreach camp format, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided biopsy, imprint cytology of biopsy specimens and surgical treatment or referral, were offered within a single visit.
resultsEleven hundred and twenty-nine (1129) women attended the camps for breast care. Mean age was 35.9 years. The majority were multiparous (79.4%), breast-fed (76.0%), and reported hormone use (50.4%). Abnormalities were detected on clinical breast examination in 122 (10.8%) women, 114 of whom required ultrasound. Of the 114 who underwent ultrasound, 48 had identifiable lesions and were evaluated with ultrasound-guided core needle biopsy (39) or fine-needle aspiration (9). The concordance between imprint cytology and histopathology was 100%, when breast specimens were classified as either benign or malignant. However, when specimens were classified by histopathologic subtype, the concordance between imprint cytology and histology was 85.7% for benign and 100% for malignant lesions. Six (6) women were diagnosed with invasive cancer. Eighteen (18) women with symptomatic breast lesions had next-day surgery. SIGNIFICANCE: Similar to its impact on cervical cancer prevention services, a single visit breast care algorithm has the potential to overcome health system-related barriers to timely diagnosis of breast diseases, including cancer, in rural African settings.
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