Breast Cancer Diagnostic Efficacy in a Developing South-East Asian Country

Document Type : Research Articles


1 St Matthews Catholic School, Mudgee, New South Wales, Australia.

2 Faculty of Health Sciences, The University of Sydney, Australia.

3 Department of Medical Imaging, Ho Chi Minh City University of Medicine and Pharmacy, Vietnam.

4 Department of Diagnostic Imaging, Vietnam National Cancer Hospital, Vietnam.

5 Singapore Eye Research Institute, Singapore.


Background: Breast cancer, is increasing in prevalence amongst South East (SE) Asian women, highlighting the
need for high quality, early diagnoses. This study investigated radiologists’ detection efficacy in a developing (DC)
and developed (DDC) SE Asian country, as compared to Australian radiologists. Methods: Using a test-set of 60
mammographic cases, 20 containing cancer, JAFROC figures of merit (FOM) and ROC area under the curves (AUC)
were calculated as well as location sensitivity, sensitivity and specificity. The test set was examined by 35, 15, and
53 radiologists from DC, a DDC and Australia, respectively. Results: DC radiologists, compared to both groups of
counterparts, demonstrated significantly lower JAFROC FOM, ROC AUC and specificity scores. DC radiologists had
a significantly lower location sensitivity than Australian radiologists. DC radiologists also demonstrated significantly
lower values for age, hours of reading per week, and years of mammography experience when compared with other
radiologists. Conclusion: Significant differences in breast cancer detection parameters can be attributed to the experience
of DC radiologists. The development of inexpensive, innovative, interactive training programs are discussed. This nonuniform
level of breast cancer detection between countries must be addressed to achieve the World Health Organisation
goal of health equity.


Main Subjects