The state of affairs of the public sector mammography service in the Free State Pprovince of South Africa

Abstract

Background: The Cancer Association of South Africa stated that breast health services in South Africa were “fragmented and not comprehensive.” The aim of study was to investigate the current state of public sector mammography in the Free State, and to recommend a way forward.
Method: A retrospective review of data was performed. Data on all female patients who received mammograms at Universitas Academic Hospital, Bloemfontein, South Africa from April 2008 to March 2010 were evaluated, as well as data on patients diagnosed with breast cancer during this period. A comparison was made between the number of mammograms performed and the number of breast cancer diagnoses during these two years at the hospital. A literature review of screening protocols and burden of disease was also carried out.
Results: A complete mammography service breakdown occurred during June 2009. During service breakdown, an average reduction of 72% was observed in the number of mammograms performed monthly, while a reduction of 41% in breast cancer diagnoses occurred. However, breast cancer has a lower burden of disease compared to many other diseases in South Africa. Effective management of breast cancer has a much greater impact on patient outcomes than screening, and should receive priority.
Conclusion: Breast health services, specifically mammography, are very limited in the Free State. However, priority may be given to other disease with a greater burden. Breast health care should initially focus on effective management of breast cancer.

Keywords: mammography, breast cancer, public sector, Free State, South Africa