Overview of Breast Health Care Guidelines for Countries with Limited Resources

Abstract

Among women around the globe, breast cancer is both the most common cancer and the leading cause of cancer-related death. Women in economically disadvantaged countries have a lower incidence of breast cancer, but poorer survival rates for the disease relative to women in affluent countries. Evidence suggests that breast cancer mortality can be reduced if resources are applied to the problem in a systematic way. The purpose of the Global Summit Consensus Conference was to begin a process to develop guidelines for improving breast health care in countries with limited resources-those with either low- or medium-level resources based on World Health Organization (WHO) criteria. Breast cancer experts and patient advocates representing 17 countries and 9 world regions participated in the conference. They reviewed the existing breast health guidelines, which generally assume unlimited resources. Individual panels then discussed and debated how limited resources can best be applied to improve three areas of breast health care--early detection, diagnosis, and treatment--and how to integrate these areas in building a breast health care program. The panelists unanimously agreed on the guiding principle that all women have the right to access to health care. They also agreed that collecting data on breast cancer is imperative for deciding how best to apply resources and for measuring progress. The panelists acknowledged the considerable challenges in implementing breast health care programs when resources are limited, as well as the need to build a program that is specific to each country's unique situation. The panelists noted that the development of centralized, specialized cancer centers may be a cost-effective way to deliver breast cancer care to some women when it is not possible to deliver such care to women nationwide. In countries with limited resources, at least half of the women have advanced or metastatic breast cancer at the time of diagnosis. Because advanced breast cancer has the poorest survival rate and is the most resource intensive to treat, measures to reduce the stage at diagnosis are likely to have the greatest overall benefit in terms of both survival and costs. Women should have access to diagnosis and treatment if efforts are undertaken to improve early detection of breast cancer. The panels' findings outline specific steps for prioritizing the use of limited resources to decrease the impact of breast cancer around the globe.

Evaluation on the Practice and Behaviour of Women Applied for Gynecology Outpatient Clinics About Screening Methods for Early Diagnosis of Breast Cancer

“…The effectiveness of a screening program provides information on the level of development of countries. While breast cancer is diagnosed at an early stage in developed countries (Stages 0 and 1), it is made at later stages in developing countries (11). For that reason, it is extremely critical to conduct a cost-effective and sufficient screening program and raise the awareness of healthcare professionals.…”

Average years of life lost due to breast and cervical cancer and the association with the marginalization index in Mexico in 2000 and 2010

“…Although data shows that YLL due to cervical cancer declined considerably between 2000 and 2010, it is crucial to continue and to strengthen actions directed at education, prevention and continuous monitoring of breast cancer. Socioeconomic disparities in Mexico shown by the different marginalization indexes, confirm the need for interventions adjusted to multiple lifestyles and living conditions 7,27,28,29 . The trends in mortality from breast cancer, cervical cancer and YLL observed by this study are consistent with findings of studies in other Latin American countries where mortality rates due to breast cancer have surpassed cervical cancer 30,31 .…”

The Approach of General Surgeons to Oncoplastic and Reconstructive Breast Surgery in Turkey: A Survey of Practice Patterns

“…When we queried the role of the general surgeon in OBS, 53.8% of surgeons believed the general surgeon should carry out this procedure himself if able to, whereas 18% preferred to enlist the help of a plastic surgeon. The difficulties associated with breast diseases in countries with limited resources are well documented (16). The limited number of plastic surgeons in Turkey has contributed to a situation where general surgeons use and develop reconstructive techniques in their own procedures.…”