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Effectiveness of clinical breast examination as a ‘stand-alone’ screening modality: an overview of systematic reviews
- Source :
- BMC Cancer, BMC Cancer, Vol 20, Iss 1, Pp 1-10 (2020), Ngan, T T, Nguyen, N T Q, Van Minh, H, Donnelly, M & O'Neill, C 2020, ' Effectiveness of clinical breast examination as a 'stand-alone' screening modality-an overview of systematic reviews ', BMC Cancer, vol. 20, no. 1, pp. 1070 . https://doi.org/10.1186/s12885-020-07521-w
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background There is uncertainty about the effectiveness of clinical breast examination (CBE) and conflicting recommendations regarding its usefulness as a screening tool for breast cancer. This paper provides an overview of systematic reviews that assessed the effectiveness of CBE as a ‘stand-alone’ screening modality for breast cancer compared to no screening and focused on its value in low- and middle-income countries (LMICs). Methods We searched MEDLINE, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for systematic reviews reporting the effectiveness of CBE published prior to October 29, 2019. The main outcomes assessed were mortality and down staging. The AMSTAR 2 checklist was used to assess the methodological quality of the reviews including risk of bias. Results Eleven systematic reviews published between 1993 and 2019 were identified. There was no direct evidence that CBE reduced breast cancer mortality. Indirect evidence suggested that a well-performed CBE achieved the same effect as mammography regarding mortality despite its apparently lower sensitivity (40–69% for CBE vs 77–95% for mammography). Greater sensitivity was recorded among younger and Asian women. Moreover, CBE contributed between 17 and 47% of the shift from advanced to early stage cancer. Conclusions CBE merits attention from health system and service planners in LMICs where a national screening programme based on mammography would be prohibitively expensive. In particular, it is likely that considerable value would be gained from conducting implementation scientific research in countries with large numbers of Asian women and/or where younger women are at higher risk. Registration PROSPERO, registration number CRD42019126798.
- Subjects :
- Cancer Research
medicine.medical_specialty
Cost-Benefit Analysis
Breast cancer mortality
Scopus
MEDLINE
Breast Neoplasms
lcsh:RC254-282
LMICs
03 medical and health sciences
Breast cancer
0302 clinical medicine
SDG 3 - Good Health and Well-being
Genetics
Humans
Medicine
Mammography
030212 general & internal medicine
Early Detection of Cancer
Clinical breast examination
medicine.diagnostic_test
business.industry
Breast Self-Examination
Systematic reviews
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
medicine.disease
Checklist
Survival Rate
Systematic review
Oncology
030220 oncology & carcinogenesis
Family medicine
Female
business
Research Article
Subjects
Details
- ISSN :
- 14712407
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....434fec3801d4f5120bd101fe8b49f848