Breast Surgery International (BSI) was formed in 1999 as an integrated society within the International Surgical Society ISS/SIC. One goal is to promote breast surgery world wide and focus on the situation in the developing countries. An edited summary of a symposium on locally advanced breast cancer (LABC) and the current situation in two African countries and in Malaysia is reported. Diagnosis, management and treatment options differ from recommendations that prevail due to lack of resources, lack of access to facilities and cultural and socioeconomic barriers. Younger age at onset, more men are affected and locally advanced breast cancer dominates the clinical panorama. A rational treatment plan for LABC should have chemotherapy, surgery, radiotherapy and hormonal therapy as armaments. A unique opportunity exists for international interchange within a professional organization such as BSI, for providing training opportunities, for clinical and experimental studies of the world' s most common female malignancy.

We report on a case of total colonic aganglionosis successfully treated by a modified Martin procedure under the specific environmental circumstances of a developing country. The single-approach procedure comprises a preservation of the ileocaecal valve and a long ileum patch for the remaining colon and rectum after left hemicolectomy with the advantage of restitution of normal stool habits due to enhanced absorption function of the remaining colon.

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