Plan to Expand Breast, Obstetric Imaging Programs in Underserved Region of Uganda

Radiologists are in the process of implementing a program in an underserved region of Uganda for diagnosing and treating women with palpable breast masses.

The program combines a unique diagnostic algorithm along with targeted community outreach, reported medical student Chris Duncan working with the organization Imaging the World (Ntinda, Uganda). Imaging the World, a nonprofit organization focused on bringing diagnostic imaging to underserved areas worldwide, has multiple obstetrical imaging programs currently operating in Uganda and plans to expand both the obstetric imaging and breast imaging programs.

“We just returned from a trip to Kamuli, Uganda, where we laid the groundwork for implementation of the diagnostic algorithm,” said Mr. Duncan, a fourth-year medical student at the University of Vermont (Burlington, USA). “Our team met with local stakeholders, determined available treatments, and identified potential barriers,” he said. “The meetings helped ensure that we can create appropriate local resources prior to our program roll-out this summer.”

The diagnostic algorithm is devised to be simpler and more effective than the current course of breast cancer diagnosis and treatment for women in Uganda, a region where most breast-cancer patients are diagnosed with late stage breast cancer, noted Mr. Duncan.

The algorithm focuses on breast ultrasound as an initial diagnostic application for assessing palpable breast masses. The breast ultrasound exam is performed by minimally trained personnel who follow a standardized scanning methodology. The ultrasound images are then compressed, uploaded to a server through a cellular network, and interpreted at another location by an imaging expert. In the United States, research continues to evaluate the quality of the images gathered using the algorithm, with early findings suggesting that the images are more than sufficient for assessing breast masses, according to Mr. Duncan.

After the images are interpreted, the findings are sent back to the clinic where the ultrasound was performed. If the results indicate the need for a biopsy, the patient is referred to the district referral hospital. “We have trained local surgeons to perform both fine-needle and core biopsies using ultrasound guidance,” said Mr. Duncan. If the biopsy is positive for cancer, the patient is referred to the major tertiary referral hospital in the capital city for treatment. “We are hiring a patient care navigator to assist women in the complicated and daunting process of receiving breast cancer care,” said Mr. Duncan. “We are also working on obtaining funding for a lodging area where the women can stay during their treatment period in the capital city.”

Patient education is vital, stressed Mr. Duncan. There are some individuals in the community that believe that cancer is contagious, that surgery spreads cancer throughout the body or that cancer is due to evil spirits, curses, and various other supernatural beliefs. “We hope that our education campaign will help to eradicate these myths, opening the path to early diagnosis and effective care for these women,” said Mr. Duncan.

The Uganda breast imaging program details were presented April 16, 2013, in an electronic exhibit featured at the American Roentgen Ray Society (ARRS) annual meeting, held in Washington DC (USA).

Related Links:
Imaging the World
University of Vermont