| Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. | |
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MedLine Citation:
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PMID: 18816619 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Breast cancer outcomes in low- and middle-income countries (LMCs) correlate with the degree to which 1) cancers are detected at early stages, 2) newly detected cancers can be diagnosed correctly, and 3) appropriately selected multimodality treatment can be provided properly in a timely fashion. The Breast Health Global Initiative (BHGI) invited international experts to review and revise previously developed BHGI resource-stratified guideline tables for early detection, diagnosis, treatment, and healthcare systems. Focus groups addressed specific issues in breast pathology, radiation therapy, and management of locally advanced disease. Process metrics were developed based on the priorities established in the guideline stratification. The groups indicated that cancer prevention through health behavior modification could influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies. Government intervention is needed to address drug-delivery problems relating to high cost and poor access. Guideline dissemination and implementation research plays a crucial role in improving care. Adaptation of technology is needed in LMCs, especially for breast imaging, pathology, radiation therapy, and systemic treatment. Curricula for education and training in LMCs should be developed, applied, and studied in LMC-based learning laboratories to aid information transfer of evidence-based BHGI guidelines. |
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Authors:
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Benjamin O Anderson; Cheng-Har Yip; Robert A Smith; Roman Shyyan; Stephen F Sener; Alexandru Eniu; Robert W Carlson; Edward Azavedo; Joe Harford |
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Publication Detail:
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Type: Congresses; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Cancer Volume: 113 ISSN: 1097-0142 ISO Abbreviation: Cancer Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-16 Completed Date: 2009-03-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374236 Medline TA: Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 2221-43 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of Washington, Seattle, Washington 98195, USA. banderso@u.washington.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Breast* Breast Neoplasms* / diagnosis, prevention & control, surgery, therapy Delivery of Health Care / standards* Developing Countries / economics* Early Detection of Cancer Female Health Humans Income Neoplasm Staging Practice Guidelines as Topic* Risk Reduction Behavior Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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1 R13 HS017218-01/HS/AHRQ HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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