Evidence map›Paper›PMID 33405960›Full record

ArticleJCO global oncology2021

Impact of Community-Based Clinical Breast Examinations in Botswana.

Michael Dykstra, Brighid Malone, Onica Lekuntwane, Jason Efstathiou, Virginia Letsatsi, Shekinah Elmore, Cesar Castro, Neo Tapela, Scott Dryden-Peterson

Open access · goldAbstract read
In one paragraph

Article in JCO global oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Quality of life among non-metastatic breast cancer survivors in Botswana.Journal of cancer survivorship : research and practice · 2025
    Article
  2. Article
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Michael DykstraBeth Israel Deaconess Medical Center, Boston, MA.
Brighid MaloneBokamoso Private Hospital, Gaborone, Botswana.
Onica LekuntwaneJourney of Hope Botswana, Gaborone, Botswana.
Jason EfstathiouMassachusetts General Hospital, Boston, MA.
Virginia LetsatsiBotswana Ministry of Health and Wellness, Gaborone, Botswana.
Shekinah ElmoreDepartment of Radiation Oncology, University of North Carolina, Chapel Hill, NC.
Cesar CastroMassachusetts General Hospital, Boston, MA.
Neo TapelaBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Scott Dryden-PetersonBotswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Botswana Harvard AIDS Institute Partnership · BWMassachusetts General Hospital · USBotswana Open University · BWHarvard University · USMinistry of Health · BWUniversity of North Carolina at Chapel Hill · US

Funding

Smartphone for molecular cancer diagnostic in AfricaUH3CA202637 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI CHABNER, BRUCE ALLAN, WEISSLEDER, MD, PHD, RALPH · 2018 to 2020
$2.9M
Covid-19-related cervical cancer treatment interruption and role of neoadjuvant chemotherapyR01CA236546 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI DRYDEN-PETERSON, SCOTT · 2019 to 2023
$2.5M
NCI NIH HHS R01 CA236546NCI NIH HHS UH3 CA202637
6 · The paper itself

Abstract

purposeWe evaluated a clinical breast examination (CBE) screening program to determine the prevalence of breast abnormalities, number examined per cancer diagnosis, and clinical resources required for these diagnoses in a middle-income African setting.

methodsWe performed a retrospective review of a CBE screening program (2015-2018) by Journey of Hope Botswana, a Botswana-based nongovernmental organization (NGO). Symptomatic and asymptomatic women were invited to attend. Screening events were held in communities throughout rural and periurban Botswana, with CBEs performed by volunteer nurses. Individuals who screened positive were referred to a private tertiary facility and were followed by the NGO. Data were obtained from NGO records.

resultsOf 6,120 screened women (50 men excluded), 452 (7.4%) presented with a symptom and 357 (5.83%) were referred for further evaluation; 257 ultrasounds, 100 fine-needle aspirations (FNAs), 58 mammograms, and 31 biopsies were performed. In total, 6,031 were exonerated from cancer, 78 were lost to follow-up (67 for ≤ 50 years and 11 for > 50 years), and 11 were diagnosed with cancer (five for 41-50 years and six for > 50 years, 10 presented with symptoms). Overall breast cancer prevalence was calculated to be 18/10,000 (95% CI, 8 to 29/10,000). The number of women examined per breast cancer diagnosis was 237 (95% CI, 126 to 1910) for women of age 41-50 years and 196 (95% CI, 109 to 977) for women of age > 50 years. Median time to diagnosis for all women was 17.5 [1 to 32.5] days. CBE-detected tumors were not different than tumors presenting through standard care.

conclusionIn a previously unscreened population, yield from community-based CBE screening was high, particularly among symptomatic women, and required modest diagnostic resources. This strategy has potential to reduce breast cancer mortality.

Indexed as

Breast NeoplasmsMammographyAdultBotswanaFemaleHumansMass ScreeningMiddle AgedRetrospective Studies

Identifiers

PMID33405960
PMCPMC8081526
OpenAlexW3119937703

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.