Authors: Benjamin O. Anderson, Joseph Lipscomb, Raul Murillo, David B. Thomas
Breast cancer is the world’s most common cancer among women, and its incidence is increasing in low- and middle-income countries (LMICs). Reducing risk factors will show little effect since most like age and genetic history cannot change. The Breast Health Global Initiative (BHGI) has developed guidelines to improve early detection and treatment which will enhance outcomes. Early detection involves mammographic screening, clinical breast examinations, breast self-examinations, and breast awareness education while diagnosis focuses on clinical evaluation, diagnostic imaging, tissue sampling, and tumor markers. Treatment such as modified radical mastectomy is the mainstay and when available, radiation therapy and systemic pharmacotherapy (including chemotherapy) may also produce positive outcomes. Before an LMIC initiates a breast cancer control program or evaluates existing programs, careful assessment of the local situation is needed to look at social and cultural barriers and identify target groups. Cost-effective interventions can be developed in LMICs as shown by Vietnam and the Republic of Korea.