Oncologist Perspectives on Breast Cancer Screening in India- Results from a Qualitative Study in Andhra Pradesh

Background: It is important to understand the perceptions of oncologists to understand the comprehensivepicture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involvingpatients of breast cancer in India should provide insights into stages of breast cancer with which women presentto their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and
Methods:A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentationof breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent inAndhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various publicand private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening.The data were triangulated to draw inferences suitable for the current public Health scenario.
Results: Latepresentation was indicated as the most important cause of decreased survival among women. Most women presentat Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a hugegap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Evendespite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance,negligence, and easy going attitude.
Conclusions: It is important to improve awareness about breast cancer andscreening methods for promoting early screening. The study inferred that it would be beneficial to establishcancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods(breast self examination (BSE), clinical breast examination and mammography) can best be used as a screeningtool and how to successfully implement population wide screening program to prevent mortality and morbidityfrom breast cancer in India.