Diagnostic mobile mammography integration with CBE for early detection in rural Naryn, Kyrgyzstan

Public Foundation "Ergene" - Kyrgyzstan

As part of the Breast Cancer programme, this project was awarded a grant for early detection of breast cancer in October 2022.

Project objectives

This ambitious project aimed to reach women in the rural mountainous region of Naryn, Kyrgyzstan with a mobile mammography unit and provide needed breast health information to the population and to doctors in the region. In a previous project, the team found that there was a lack of knowledge amongst family physicians regarding referral and that it was critical also to strengthen the referral pathway to diagnosis.

Project description

The team utilised the outreach to conduct focus group discussions with women and doctors in rural community to better understand the barriers faced by both groups. After identifying barriers to treatment, which included healthcare worker hesitancy due to lack of knowledge, the team trained 188 family doctors and nurses in 53 family medicine centres to identify breast cancer risk and make referrals for mammography. These trained staff then supported the project by examining women, and referring symptomatic women and women with high-risk factors for mammography.

The project and primary health care services performed Clinical Breast Examination (CBE) on 18,350 women and further referred women with suspicious abnormalities to an oncology centre for verification of diagnosis and cancer treatment. Of the 3,950 women referred for mammography with complaints of breast pain and thickening, 132 women had suspicious abnormalities, and 22 women had stage 1-2 cancer. Notably, in the year prior to the project (2022), only 1 women had been diagnosed for breast cancer in the region. Through persistent patient navigation activities, including linking women to necessary services and following up through WhatsApp, all 132 women got a biopsy within 60 days, and the 22 women with cancer received treatment.

Impact

Following the grant, the project team engaged in discussions with WHO on the establishment of regional mammography services. The Kyrgyz Ministry of Health has since committed to procuring seven mammography units for regional family medicine centres and to using mobile mammography services to reach remote mountainous areas.