JNCI – Clinical Breast Examination: Preliminary Results from a Cluster Randomized Controlled Trial in India

Early detection and appropriate treatment is the major approach for breast cancer control. However, mammography screening is neither feasible nor affordable in many developing countries where breast cancer incidence is rapidly increasing. The Regional Cancer Centre, Trivandrum, India and the International Agency for Research on Cancer initiated a cluster randomized controlled trial involving 116,000 women in the Trivandrum district (India) in 2006 to evaluate whether three rounds of triennial clinical breast examination (CBE), an alternative to mammography screening,  can reduce the inci­dence of advanced disease and breast cancer mortality. Preliminary results after one round of screening indicates two fold increased earlier detection of breast cancer in women randomized to CBE screening as compared to women receiving routine existing care in the control group. Further follow-up will clarify if whether earlier detection following CBE screening will lead to significant reduction in breast cancer mortality.
   
R Sankaranarayanan, K Ramadas, S Thara, R Muwonge, J Prabhakar, et al.
Clinical Breast Examination: Preliminary Results from a Cluster Randomized Controlled Trial in India
JNCI J Natl Cancer Inst (2011) doi: 10.1093/jnci/djr304
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