Abstract P1-02-06: Breast cancer screening in the Republic of Belarus: Advantages and learning perspective

Background: Breast cancer (BC) is the most common cancer among women in the Republic of Belarus. To reduce BC-related mortality, the implementation of organized pilot BC screening programmes using digital mammography has been supported by the European Union as part of the BELMED project. During recent years Belarus has developed its own digital mammographs and software that allows storing and processing images in the DICOM format. To assure digital mammographic performance in the local context, the first external clinical image quality assessment (QA) of Belarus mammograms was performed by a leading UK radiologist. Methods: The reviewed mammograms from 88 (out of 2,267) Belarus women (mean age: 59.5 years; SD:5.7) attending the a breast screening pilot in Minsk were examined as 81 with positive and 7 with negative findings, according to Belarus readers. This included all 10 histologically confirmed BCs. Within the framework of BELMED project, a total of 400 mammographic images were selected for evaluation by a leading expert radiologist from the UK Public Health England Breast Screening Programme. Evaluated mammographic images were classified according to the Belarus (non-BIRADS) and BIRADS (the UK radiologist) categories, associtated with a follow-up plan. Gradings were compared across categories (the Cohen9s Kappa) and according to the proportion of cases referred for further tests (the Wilcoxon signed rank test). Results: The reviewer concluded that approximately 50% of the positive mammograms didn9t require futher assessment in screening according to the UK radiologist. All histologically confirmed BCs were not among those downgraded. Substantial agreement was found in the gradings for BC (Kappa: 0.66, p Conclusions: To minimize additional tests on women, comprehensive QA (audit and regular check of mammographic technique, the opinion of physicists, etc.) is essential. Applying the implementation research may result in further improvement of the national BC programme. Improved practice can be promoted by continous image review and training for individual staff (i.e., through BELMED, in collaboration with UK training centres) to further improve the skills of Belarus specialists and increase the quality of BC screening programme in Belarus. Citation Format: Trusova O, Osharin V, Smelov V, Wilkinson L, Given-Wilson R. Breast cancer screening in the Republic of Belarus: Advantages and learning perspective [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-06.