Breast cancer management in low resource countries (LRCs): Consensus statement from the Breast Health Global Initiative

Abstract

The Breast Health Global Initiative (BHGI) brought together international breast cancer experts to discuss breast cancer in low resource countries (LRCs) and identify common concerns reviewed in this consensus statement. There continues to be a lack of public and health care professionals' awareness of the importance of early detection of breast cancer. Mastectomy continues to be the most common treatment for breast cancer; and a lack of surgeons and anesthesia services was identified as a contributing factor in delayed surgical therapy in LRCs. Where available, radiation therapy is still more likely to be used for palliation rather than for curative treatment. Tumor receptor status is often suboptimally performed due to lack of advanced pathology services and variable quality control of tissue handling and processing. Regional pathology services can be a cost-effective approach and can serve as reference, training and research centers. Limited availability of medical oncologists in LRCs often results in non-specialist providing chemotherapeutic services, which requires additional supervision and training. Palliative care is an emerging field in LRCs that requires investment in training and infrastructure development. A commitment and investment in the development of breast cancer care services by LRC governments and health authorities remains a critical need in LRCs.

Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

“…It is also estimated that more than 269000 out of 480000 deaths caused by breast cancer happen in developing countries. This is due to the fact that survival rate has improved in developed countries (Yip et al, 2008;El Saghir et al, 2011;Story HL et al, 2012).…”

“…In the United States, the mortality rate of the disease has decreased into 2.2% per year during 1990-2007, which is attributed to screening programs and new therapeutic strategies (Altekruse et al, 2010). However, the global burden of breast cancer is increasing in low-income and middle-income countries (LMCs) and it is considered as a threatening factor for their health systems (El Saghir et al, 2011;Story HL et al, 2012). It's a common misconception that the incidence of breast cancer is high in developed countries.…”

“…In Iran, according to the Breast Health Global Initiative Guideline (BHGI-2008) (Yip et al, 2008;El Saghir et al, 2011), which is a resource-sensitive guideline, HER-2/neu assessment and trastuzumab treatment are recommended for breast cancer. Several studies in Iran show that both the incidence of breast cancer and its mortality rate are increasing (Mousavi et al, 2006;Mousavi et al, 2009;Taghavi et al, 2012).…”

Optimal Systemic Therapy for Early Breast Cancer in Women: A Clinical Practice Guideline

“…The local practice setting, including resource constraints, has to be heeded when considering implementation of systemic therapy recommendations. Guidelines by groups such as the Breast Health Global Initiative [81][82][83] could help users of this guideline to better choose the most resource-appropriate systemic therapies for their unique practice setting.…”

Parametric Modeling of Survival Times Among Breast Cancer Patients in a Teaching Hospital, Osogbo

“…The breast cancer burden differs between countries and regions showing variations in incidence, mortality and survival rates. Early diagnosis of breast cancer is known to be vital not just in the treatment of the disease but also in determining prognosis [5]. Incidence rates are higher in the developed countries than in the developing countries.…”