Abstract:
Although incidence, mortality, and survival rates vary fourfold in the world’s regions, in the world as a whole, the
incidence of breast cancer is increasing, and in regions without early detection programs, mortality is also increasing. The growing
burden of breast cancer in low-resource countries demands adaptive strategies that can improve on the too common pattern of
disease presentation at a stage when prognosis is very poor. In January 2005, the Breast Health Global Initiative (BHGI) held its
second summit in Bethesda, MD. The Early Detection and Access to Care Panel reaffirmed the core principle that a requirement
at all resource levels is that women should be supported in seeking care and should have access to appropriate, affordable diagnostic tests and treatment. In terms of earlier diagnosis, the panel recommended that breast health awareness should be promoted
to all women. Enhancements to basic facilities might include the following, in order of resources: effective training of relevant staff
in clinical breast examination (CBE) both for symptomatic and asymptomatic women; opportunistic screening with CBE; demonstration projects or trials of organized screening using CBE or breast self-examination; and finally, feasibility studies of mammographic screening. Ideally, for complete evaluation, such projects require notification of deaths among breast cancer cases and
staging of diagnosed tumors.
