Imaging-based Breast Cancer Screening: A Comparative Study of Screening Pathways in Three Healthcare Facilities in Libya

الملخص

The problem of breast cancer is very significant in the contemporary world, as it  represents one of the most common causes of death among women due to late diagnoses. Therefore, early diagnosis is necessary to improve the prognosis of the disease and select the optimal treatment. The main imaging technique used to diagnose breast cancer is mammography that detects even slight changes in tissues. However, its effectiveness decreases in women with dense breasts since it reduces the sensitivity of the test and increases the risk of missing certain abnormalities. In this case, ultrasonography is used as a complementary diagnostic technique to improve the results.

Although clinical examination, imaging, and biopsy are standard practices used in all countries for breast cancer detection, the sequence of the procedures differs, especially concerning imaging techniques. Therefore, a comparison of the existing techniques was needed to develop a unified national program. Thus, a retrospective cross-sectional study was conducted on the records of 1150 female patients with an average age of 47 years, ranging between 15 and 65 who had been exposed to ultrasound and mammography in three Libyan medical centers during the year 2021.

The records from three centers revealed that cases were referred to mammography units straightaway after self and  physical examination in 713 cases (62%), while in 437 (38%) cases, patients were referred to physicians after ultrasound imaging. From the findings of the questionnaires, it was discovered that almost all mammography pictures taken were from Automatic Exposure Control (AEC)