Summary
This journal article aims to investigate the outcomes of diagnostic breast ultrasound performed by non-radiologist clinicians in a breast ultrasound training and mentorship program at a rural Rwandan hospital. The goal is to enhance early detection of breast cancer in low- and middle-income countries.
During the study, data on imaging findings, management plans, and pathologic results were collected prospectively using standardized forms. The study analyzed 229 breast palpable findings in 199 patients. Of these, 38 lesions were initially identified as malignant, with an additional 3 being classified as malignant on repeat biopsy. All 34 patients ultimately diagnosed with cancer initially received recommendations for biopsy or aspiration from trainees. The positive predictive value of biopsy recommendations made by trainees was 34.8%, and the sensitivity for identifying malignant lesions was 92.7%.
However, the study also noted that a significant percentage of patients instructed to return for clinical or imaging follow-up did not return (37.0%). This highlights the challenge of follow-up in resource-constrained settings. The authors suggest that lower biopsy thresholds, decentralized surveillance, or patient navigation may be necessary for patients with low- or intermediate-suspicion lesions.
In conclusion, the study demonstrates the successful identification of suspicious breast lesions by trained nonradiologist clinicians in Rwanda. It also highlights the need for improved follow-up strategies for patients with low- or intermediate-suspicion lesions to enhance early breast cancer detection in low-resource settings.
