Effectiveness of triennial screening with clinical breast examination: 14-years follow-up outcomes of randomized clinical trial in Trivandrum, India

In a new study, scientists from the International Agency for Research on Cancer (IARC) and partner institutions describe the long-term impact of screening women aged 30–69 years with clinical breast examination (CBE) every 3 years. This study, which was published in the journal Cancer, is only the second randomized controlled trial to be published on long-term outcomes of CBE screening.

The researchers randomized nearly 115 000 women to either the study’s intervention arm (with CBE screening) or the control arm (with existing routine care). They observed significant downstaging of breast cancers (i.e. a shift towards earlier stage at detection) and improved survival in the women randomized to the screening arm compared with those in the control arm. However, no significant reduction in breast cancer-specific mortality was observed after 14 years of follow-up.

The women in the control arm were provided with materials to raise awareness about breast cancer, its early signs, and the importance of early detection, and they had access to good-quality diagnostic and treatment services.

The study results may indicate that improving breast awareness and ensuring access to timely treatment (an early diagnosis pathway) are almost as good as systematic CBE screening in reducing mortality from breast cancer. CBE is a valuable tool for diagnosis of breast cancer in symptomatic women, especially in areas where mammography and/or breast cancer screening programmes are not widely available. This information will be very useful in the context of developing strategies for the Global Breast Cancer Initiative, recently launched by the World Health Organization.

Ramadas K, Basu P, Mathew BS, Muwonge R, Venugopal M, Prakasan AM, et al.
Effectiveness of triennial screening with clinical breast examination: 14-years follow-up outcomes of randomized clinical trial in Trivandrum, India
Cancer, Published online 1 November 2022;
https://doi.org/10.1002/cncr.34526

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