Community Screening of Breast Cancer

'Early detection' remains the most important strategy to counter the growing scourge of BC. However, lack of awareness in women about disease symptoms, screening modalities, self-examination and/or routine mammographic screening leads to negligence, thereby, resulting in costly delay in diagnosis and treatment. Various strategies have been deployed in several developed countries to tackle the BC menace. These include:

The United States Centre for Disease Control (US-CDC) is actively running a successful National Breast and Cervical Early Detection Program (NBCCEDP). However, despite the rapid rise of BC cases in urban India, there is no presence of a government-initiated community BC screening program.

In 2012 - PCCM created a mobile breast cancer screening unit with generous support from a few socially conscious corporate houses. This unit is a full-sized bus equipped with a mammography machine, a mini-operation theatre, a small medical consultation area and a picture archiving and communication system (PACS). As per medical guidelines, primary healthcare workers (PHWs) organize community awareness drives, offer training on SBE techniques. Well-trained female nurses on this bus routinely perform CBE and mammography. These mammograms are then evaluated by well-trained breast radiologists at OBHC. If an abnormality is detected, the women are requested to come to OBHC for further medical follow-up and treatment at subsidized cost. This mobile van travels to many parts of Pune city as well as its fringe areas targeting women from low resource settings.

The 'Hub-and-Spoke' Model for the Community Breast Cancer Screening Program

From January 2016 Tata Trusts, India's largest philanthropic organization, has partnered with PCCM as part of its 'Social Innovation Program' to scale-up this BC screening program in Pune. Multiple mobile diagnostic vans are now operational in Pune city with a target to sensitize and screen large number of women. This program is exhaustive, non-discriminatory, and affordable to all sections of the society. Largely based on a cross-subsidy economic model, the program generates revenues from subsidized charges to the affording women (in comparison to hospital-based services). This corpus then allows free screening of women from the underprivileged strata of the society. Linkages to governmental public-health infrastructure helps reduce overall project costs (by using its paramedics and existing facilities in hospitals and urban-centers), increase outreach and promotion (by using the government's messaging platforms); and create systems & processes of working with the government system (which is the only media for facilitating state-wide adoption in India).

Breast Cancer Screening Camps

Scalability & Sustainability of Social Innovations in Public Health

The current community BC screening model at PCCM has been recognized as a high-impact social innovation project. Post-implementation, this model will be evaluated as part of Health Outcomes Research in order to study the clinical impact, cost-effectiveness, scalability, sustainability and scope for further innovation. Based on the learning from the BC screening program, we are now in the process of developing community screening programs for Tuberculosis which is also a major health concern in India.


mHealth and ICT Applications in Breast Cancer Awareness

Self-Breast Exam (SBE) is the single-most effective way of home-based surveillance of BC. However, lack of awareness about BC and SBE is a major barrier to effective implementation in the community. We have launched a major mobile phone based campaign in Pune for SBE awareness and compliance. This free service involves consenting women receiving monthly SBE reminders via SMS and smartphone-based apps. The operation team can track the participating women for self-reported actionable abnormalities. We are in the process of streamlining operational issues of this campaign.

Community based Clinical Breast Examination (CBE)

Routine CBE in the community at large by well-trained nurses, paramedical personnel and social health workers has been shown as an effective method of BC surveillance. PCCM has now established a 'train-the-trainer-model' for community-based CBE. In collaboration with local Municipal Corporation, we train medical social workers at OBHC using scientific methods of CBE and BC medical knowledge in local language. These trained women then perform CBE on eligible women in their respective neighborhoods and work-places. The operation team can track the participating women for CBE-screened actionable abnormalities.

Affordable Technology Innovations in Cancer

In countries like India, development of low cost, feasible and user-friendly technology solutions and services is expected to improve the public health deliverables. Many start-up companies in India and abroad are innovating actively in the cancer screening and diagnostics domain. As a research-driven NGO working in cancer, PCCM has been providing active clinical and field based support to such innovators by assisting in clinical validation of their novel prototypes and services.

Traditional Indian Knowledge Base in Cancer Management

India has a rich heritage of traditional medicinal systems such as Ayurveda. With help from local Ayurveda experts, PCCM is actively involved in providing holistic care to BC patients which integrates the wisdom of traditional concepts with that of modern-day oncology. The clinicians at OBHC routinely support the use of life-style and diet changes, Ayurvedic formulations and yoga to improve the prognosis and quality-of-life of cancer patients. This philosophy of Integrative Oncology Clinical Practice has also influenced the conception of novel and interesting clinical research studies under progress.

Improving Quality-of-life of Cancer Patients

The journey through various stages of cancer can be traumatic to the BC patient. OBHC offers free psychological counseling from experts to patients and families who need support during treatment and rehabilitation. In addition, our counseling team also interacts with women who have chosen to undergo genetic testing, breast reconstruction surgery, chemotherapy.

Pink-Ribbon Patient Support Groups

The battle with BC is bearable and less burdensome if the right support from colleagues, friends and family is available. With this objective, PCCM has started an empathy-based, pink ribbon support group for BC patients and survivors. These women meet often to discuss issues close to their heart and to seek and provide support to each-other. Movie shows, musical performances, excursions, cooking shows are routinely organized to provide the much-needed recreation to cancer patients and families. This support group also organizes an annual fund-raiser to support medical management of underprivileged cancer patients.

Annual Breast Cancer Awareness Marathon

PCCM organizes 'Our Marathon'-an annual BC Awareness Marathon in Pune city since 2010. The 2015 Marathon was attended by over 12,000 runners from all walks of life which includes a special contingent of BC patients and survivors. Many prominent personalities in Pune from government, corporate sector, sports, films, media, television, and academia participate in this event as brand ambassadors.

Public Awareness and Education in Cancer

The high BC mortality in India has been attributed to lack of awareness and late detection. To bridge this information gap, PCCM actively engages with the general community in Pune by organizing awareness events such as educational lectures, public talks, meet-the-experts sessions, medical symposia. Such events are generally co-organised in collaboration with local audio-visual media, press and like-minded NGOs.


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