title: Results of a pilot programme of mammographic breast cancer screening in the Western Cape.
abstract: BACKGROUND
  Mammographic screening programmes are now established in developing countries. We present an analysis of the first screening programme in sub-Saharan Africa.
  
  
  METHODS
  Women aged > or = 40 years were identified at three primary healthcare centres in the Western Cape Province, South Africa, and after giving informed consent underwent mammography at a mobile unit. After a single reading, patients with American College of Radiology Breast Imaging Reporting and Data System (BIRADS) 3 - 5 lesions were referred to a tertiary centre for further management.
  
  
  RESULTS
  Between 1 February 2011 and 31 August 2012, 2 712 screening mammograms were performed. A total of 261 screening mammograms were reported as BIRADS 3 - 5 (recall rate 9.6%). Upon review of the 250 available screening mammograms, 58 (23%) were rated benign or no abnormalities (BIRADS 1 and 2) and no further action was taken. In 32 women, tissue was acquired (biopsy rate for the series 1.2%); 10 cancers were diagnosed (biopsy malignancy rate 31%). For the entire series of 2 712 screening mammograms, the cancer diagnosis rate was 3.7/1 000 examinations. Of 10 cancers diagnosed at screening, 5 were TNM clinical stage 0, 2 stage I and 3 stage II.
  
  
  CONCLUSIONS
  The low cancer detection rate achieved, and the technical and multiple administrative problems experienced do not justify installation of a screening programme using the model utilised in this series.
authors.forename: J P
authors.initials: JP
authors.lastname: Apffelstaedt
authors.forename: R
authors.initials: R
authors.lastname: Hattingh
authors.forename: K
authors.initials: K
authors.lastname: Baatjes
authors.forename: N
authors.initials: N
authors.lastname: Wessels
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010865:Pilot Projects; D013019:South Africa