Rapid evidence synthesis (RES) on palmer angle tri-radius for breast cancer screening in women

Breast cancer is the most commonly reported cancer among women in India with an incidence rate of 25.8 percent per 100,000 women in 2012. A key strategy of India’s National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) has been to carry out effective primary breast cancer screening among women. The Atal Bihari Vajpayee Institute of Good Governance and Policy Analysis (AIGGPA), an autonomous policy think-tank under the Government of Madhya Pradesh, requested our RES team to review the existing evidence on the usability of palmer ATD-angle measurement to accurately screen women at-risk of breast cancer. The method was perceived as cost-effective, non-invasive and accessible.

The rapid evidence synthesis thus conducted provided AIGGPA with evidence-informed policy options on the use of ATD-angle measurement as an alternative to standard breast cancer screening methods.

Key policy options are:

  1. Research done so far on ATD-angle measurement for breast cancer did not use appropriate and rigorous study designs. Further, the studies did not measure the required parameters (sensitivity and specificity) to understand if ATD-angle measurement could be used instead of CBE (alone or in conjunction with USG/mammography) for community screening.
  2. Decision-makers may consider prioritising funding for a pilot study to assess the diagnostic accuracy of ATD-angle measurement for breast cancer screening in women using an appropriate study design.

The full policy brief and technical supplement documents are available below: