Breast cancer care in Armenia: An assessment of diagnostic and treatment capacity.

Abstract

e13623 Background: Timely diagnosis and access to treatment are essential components of effective breast cancer care. Despite a growing breast cancer burden in Armenia, the availability of diagnostic and treatment services has not been comprehensively evaluated. We implemented a survey at health centers in Armenia to assess the availability of diagnostic and treatment modalities for breast cancer. Methods: We conducted a cross-sectional descriptive cohort study, employing a validated breast cancer survey adapted and translated into Armenian from the Tanzania Breast Health Care Assessment 2017 and the Sergipe 2018: Breast Healthcare Assessment. In collaboration with administrators at Armenia’s National Center of Oncology, three tertiary hospitals and one breast care facility in Yerevan, the capital city, were selected for participation in this study. These institutions were determined to be representative of the highest-capacity sites for breast cancer treatment in the country. The study was reviewed by the Yerevan State Medical University and UCLA Medical School institutional review boards and deemed exempt from human subjects research. Results: All sites reported functional MRI, ultrasound, and CT capabilities; three operate an MRI with a dedicated breast coil. Only one PET scanner is available nationwide, and is located at one of the participating institutions. All four sites reported performing breast surgery, three reported use of immunotherapy, and two reported access to radiation therapy. No site endorsed possessing a Cobalt-60 unit, and only one site reported having a linear accelerator (LINAC). Most surveyed antineoplastic agents were available at three institutions; methotrexate was reported at only one site. Two sites included gene profiling in the pathology report, two conducted BRCA 1/2 testing, and two performed bone scans. Three sites performed sentinel lymph node biopsy with blue dye, and two used radiotracer techniques. Conclusions: Diagnostic and treatment capacity for breast cancer varies across institutions in Armenia. While most surveyed diagnostic and therapeutic modalities were available at at least one site, limited access to certain advanced technologies and uneven distribution of services may require patients to seek care across multiple institutions. As this assessment reflects resource availability rather than utilization, further evaluation of patient- and system-level barriers is needed to contextualize breast cancer outcomes in Armenia.