Guidelines for breast cancer treatment in Bosnia and Herzegovina

Abstract

Breast cancer is the most common cancer among women. In Bosnia and Herzegovina, accurate data on the status of breast cancer are lacking due to the absence of a central registry. Multiple international guidelines imply that institutions that monitor breast cancer patients should have optimal therapeutic options for treatment. In addition, there have been several international consensus guidelines written on the management of breast cancer. Application of consensus guidelines have previously been demonstrated to have a positive influence on breast cancer care. The importance of specialty breast centers has previously been reported. As part of the 2021 Bosnian-Hercegovinian American Academy of Arts and Sciences (BHAAAS) conference in Mostar, a round table of multidisciplinary specialists from Bosnia and Herzegovina and the diaspora was held. All were either members of BHAAAS or regularly participate in collaborative projects. The focus of the consortium was to write the first multidisciplinary guidelines for the general management of breast cancer in Bosnia and Herzegovina. The grading system used is reported in Table 1. Statements without use of a grading system were considered standard clinical practice by our panel of experts (see Table 2). Guidelines were developed for each area of breast cancer treatment and management. These guidelines will serve as a resource for practitioners managing breast cancer in the Bosnia and Hercegovina region. This might also be of benefit to the ministry of health and any future investors interested in developing breast cancer care policies in this region of the world.

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update

“…The flowchart of searching strategy and study selection is shown in Table 1. Forty‐seven articles were strongly in favour of performing SLNB in PrBC, 2,4,6,13–56 4 articles were partially in favour, 57–60 2 articles were partially against 61,62 and 10 articles were strongly against SLNB in PrBC patients 3,5,10,63–69 . Sub‐analysis based on type of study showed that out of 47 articles which were strongly in favour of SLNB, 11 were prospective cohorts or RCTs, 5 were retrospective case series or case reports, 25 were review articles and 6 articles were guidelines.…”

“…Furthermore, National Comprehensive Cancer Network (NCCN) guidelines endorse the safety of SLNB when the patient has given informed consent as several studies support that the technique can be safely performed 54 . The Guidelines for BC Management in Bosnia and Herzegovina, also released in 2020, explicitly advise against using lymphazurin and methylene blue during pregnancy and highly suggest the use 99mTc alone for SLNB mapping in PrBC 55 . Additionally, the Chinese Society of Breast Surgery (CSBrS) 56 and the Spanish Society of Medical Oncology have published similar recommendations in 2021 4 .…”