October is Breast Cancer Awareness Month, marked in countries across the world. It helps to increase attention and support for awareness, early diagnosis, and treatment, as well as palliative care for women facing this disease.
About 1.7 million new cases and 522 000 deaths from breast cancer annually [Globocan 2012 http://gco.iarc.fr/today/home]. Breast cancer is the most common cancer in women worldwide and is the most common cause of cancer among women in most countries. In low- and middle-income countries, the incidence has been rising steadily due to increased life expectancy, changing reproductive patterns (such as later age at first childbirth and less breastfeeding), and adopting western lifestyles.
Early diagnosis remains the cornerstone of breast cancer control. When found early, and if adequate diagnosis and treatment are available, there is a good chance that breast cancer can be cured. However, curative treatment is often no longer an option if detected late. In such cases, treatment may improve the quality of life and delay disease progression. At the same time, supportive and palliative care should be readily available to relieve suffering for patients and their families.
Most women who die from breast cancer (324 000) live in low- and middle-income countries, where most women are diagnosed in late stages due to various factors. These include limited awareness on the part of the public and healthcare providers and the lack of access to timely, affordable and effective diagnosis and treatment.
WHO promotes comprehensive breast cancer control programmes as part of national cancer control plans. The recommended early detection strategies for low- and middle-income countries are to increase awareness of early signs and symptoms among healthcare providers and the public and to increase capacity for prompt diagnostic evaluation (including imaging, biopsy, and pathology services). Breast screening with mammography screening is very costly. It is feasible only in countries with good health infrastructure that can afford a long-term programme. The value of clinical breast examination is an important area of research, particularly in lower-resource settings—[WHO position paper 2014].
In November, WHO will release a new document to help countries improve their capacity to diagnose breast and other cancers early.