Mammographic Screening or Breast Cancer Awareness? Time to Ponder

Breast cancer in India is becoming the leading cause of cancer-related mortality in urban women. In developed countries, the mortality from breast cancer has decreased in the past few years attributable to better awareness of disease, screening programs, early detection and more effective treatment available. Although widely used, the screening programs running in the western countries have been a point of criticism in the recent years as they lead to increased healthcare cost and detection of otherwise benign and clinically insignificant breast lesion (both benign and malignant). Also in a developing country like ours where the awareness about breast cancer among the ladies is itself poor, whether screening is feasible and cost-effective is a matter of ongoing debate. We conducted this literature review to ascertain the importance of breast cancer awareness, breast self-examination, and clinical breast examination as effective screening tools in a resource deficient country like India.