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

Abstract

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