B reast cancer is the most common cause of cancer-related death among women worldwide, with more than 1 million women diagnosed and more than 500,000 deaths from breast cancer each year.1,2 Although breast cancer incidence is lower in developing countries when compared with the US, the mortality is often much higher. 3,4 To reduce the serious disparity in breast cancer mortality in limited-resource countries, efforts must be taken to promote early detection and the delivery of the best available treatments and support for breast cancer. Strategic health communication can perform an important role in achieving these goals. This article examines strategic health communication factors in developing and implementing effective evidence-based, economically feasible, and culturally appropriate interventions to improve breast cancer outcomes that can be applied in nations with limited healthcare resources. Communication Across the Continuum of CareHealth communication is an essential component in each phase of the continuum of cancer care.5 Strategic health communication campaigns for breast cancer prevention that use multiple channels of communication can be used to effectively disseminate relevant information regarding breast health risks to vulnerable populations and encourage adoption of health-promoting behaviors (such as

108 Background: With increasing breast cancer burden, there is need for survivorship programs in developing countries. The Indian Breast Cancer Survivors Conference is a unique initiative, to address this need in urban India. A survey of participants at this meet was conducted to aid planning of future events. Methods: Participants filled a 3-page bilingual questionnaire. Data gathered included demographics, education, treatment and side effects, health behaviors, and social impact of diagnosis. Results: Demographic: 205 breast cancer survivors registered from 5 cities. 190 participated in the study. Mean age was 51.5 years (27-79). 61.6 % reported having one or more college degrees and 86.5% were married. Diagnosis and Treatment: Mean age at diagnosis was 47.5 yrs (22-72). Median time from diagnosis was 36 m (3m-19 yrs). Mastectomy was reported as the surgical treatment by 52.1% (6% reconstruction), 72.9 % reported lymph node removal and 10.8% could not specify surgical details. 90% received chemotherapy; 76.8% underwent radiation (97.3% in lumpectomy pts); 61% took endocrine therapy and 5.1 % interrupted it before 5 years. Side Effects:Arthralgia (64%) and anxiety (60.9%) were most frequent self- reported problems followed by surgical site pain (56.1%), depression (53.9%), cognitive deficits (52.2%), skin/ hair/ nail problems (48.2%), hot flashes (48.2%), arm swelling (48.2%) and vaginal dryness (38.2%). Social Impact:Survivors whowere married or in a relationship described their relationship as stronger after diagnosis in 57.8%, unchanged in 37.4% and weaker in 4.7%. Two were married after diagnosis and none reported separation or divorce. Health Behaviors: Regular surveillance visits were reported by 93.3 % (168/180) of participants (65 with their medical oncologist, 50 with surgeon, 23 with both) 5.5% had not seen their oncologist in 2 years. Alternative medical treatment was used by 29.1% (53/182); 26 used Ayurvedic, 13 homeopathic and 14 other. This was discussed with an oncologist by 62.3%. Regular exercise at least 3 times/week was reported by 73.7% and walking (88.8%) or yoga (22.2%) were preferred. Conclusions: The presented data highlights aspects of breast cancer survivorship in urban Indian women that can be used to plan survivorship programs in future.

208 Background: In The Indian Scenario, a diagnosis of cancer is accompanied with social stigma and emotional upheavals, especially in breast cancer patients. They are typically thinking: “I would be less of a woman,” “I don’t know if people understand me,” “I feel isolated from myself, my family and my friends,” “Would I be normal again?” “Do I know how to help myself?” or “What will happen in the future, to my kids, to my husband?” Methods: All of these concerns are not always addressed by the medical professions. To address these issues, the Indian Breast Cancer Survivors Conference was organized as an annual conference with an attendance of 200-250 breast cancer survivors from the state of Maharashtra, India. The conference would address the psychological, emotional and social distress experienced by the patients with an aim from living a longer life to living a better and fulfilled life. Results: The emphasis of the sessions were educational (with recent updates on the surgical, medical and radiation therapy aspects of breast cancer treatment), practical (emphasized important issues like side-effects of treatment, patient advocacy, complementary therapies, spirituality, lifestyle changes, etc.), and entertaining. The summary and outcomes of the last 5 annual survivorship conferences will be described and enumerated. Results of questionnaires administered during the last 2 conferences and addressing health behavior patterns of survivors will be presented. Conclusions: We can evaluate through post conference support group discussions and conference feedback, qualify patient psychological and social health as 1) Physical:There are side effects but I choose to go on; 2) Mental: There are times that I am low, depressed, anxious, scared, guilty, but this is my new normal; 3) Emotional:Little things upset me, angry quickly but I am dealing with it; 4)Spiritual:Moved away from bargaining with God to accepting, from rituals to spiritual; 5) Social:don’t hesitate to reach out for support and to support; and 5) Intellectual:Knowledge is power, so I have learned to ask, to question, and then to decide. Achieving psychological and social health is the effort of the patient, the treating team and the support group.

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