World Journal of Surgery

, 33:2069 | Cite as

Breast Cancer Care in Developing Countries

  • Gaurav Agarwal
  • Pooja Ramakant
  • Ernesto R. Sánchez Forgach
  • Jorge Carrasco Rendón
  • Juan Manuel Chaparro
  • Carlos Sánchez Basurto
  • Marko Margaritoni
Article

Abstract

Background

Breast cancer is the commonest cancer of women the world over, and its incidence is rising, especially in developing countries, where the disease poses a major health care challenge. This growing incidence in developing countries reflects the advanced stage at diagnosis, low levels of public awareness of the risk for the disease, and poor medical infrastructure and expertise, with the resultant poor treatment outcomes.

Methods

This article provides a collective edited summary of the presentations at the symposium titled “Breast Cancer Care in Developing Countries,” held as part of the Breast Surgery International program at the International Surgical week 2007, Montreal, Canada, August 2007. The aim of the presentations was to bring out the diverse clinical pathological and outcomes-related facts of breast cancer care available to women in several countries. As the incidence of breast cancer continues to rise steadily in the developing world, the lack of awareness of this disease and the absence of breast cancer screening programs make it almost certain that the majority of breast cancers are diagnosed at an advanced stage. In addition, the quality of care available for breast cancer patients varies widely according to where the patient is treated.

Results

Though there are some centers of excellence providing multimodality protocol-based treatment on a par with the best anywhere in the world, most breast cancer patients receive inadequate and inappropriate treatment because of a lack of high-quality infrastructure—and sometimes skills—and, above all, because of limited financial resources.

Conclusions

In countries where these limitations are present, there is a need to emphasize public health education, promoting early diagnosis. In addition, resources must be directed toward the creation of more public facilities for cancer treatment. As these goals are met, it is likely that there will be a much-needed improvement in breast cancer care in developing countries.

References

  1. 1.
    National Cancer Registry Program [India] (2001) Ten year consolidated report of the Hospital Based Cancer Registries, 1984–1993; an assessment of the burden and care of cancer patients. Indian Council of Medical Research, New DelhiGoogle Scholar
  2. 2.
    Agarwal G, Pradeep PV, Aggarwal V et al (2007) Spectrum of breast cancer in Asian women. World J Surg 31:1031–1040PubMedCrossRefGoogle Scholar
  3. 3.
    Aggarwal V, Agarwal G, Lal P et al (2008) Feasibility study of safe breast conservation in large and locally advanced cancers with use of radiopaque markers to mark pre-neoadjuvant chemotherapy tumor margins. World J Surg 32:2562–2569PubMedCrossRefGoogle Scholar
  4. 4.
    Nandakumar A, Anantha N, Venugopal TC et al (1995) Survival in breast cancer: a population-based study in Bangalore, India. Int J Cancer 60:593–596PubMedCrossRefGoogle Scholar
  5. 5.
    National Cancer Registry Programme (2001) Consolidated report of the population based cancer registries 1990–1996. Indian Council of Medical Research, New DelhiGoogle Scholar
  6. 6.
    Murthy NS, Agarwal UK, Chaudhry K et al (2007) A study on time trends in incidence of breast cancer—Indian scenario. Eur J Cancer Care 16:185–186CrossRefGoogle Scholar
  7. 7.
    Mathew A, Pandey M, Rajan B (2004) Do younger women with non-metastatic & non-inflammatory breast carcinoma have poor prognosis? World J Surg Oncol 2:2PubMedCrossRefGoogle Scholar
  8. 8.
    Saxena S, Rekhi B, Bansal A et al (2005) Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India—a cross-sectional study. World J Surg Oncol 3:67PubMedCrossRefGoogle Scholar
  9. 9.
    Kumar BV, Lakhotia S, Ankathil R et al (2002) Germline BRCA1 mutation analysis in Indian breast/ovarian cancer families. Cancer Biol Ther 1:18–21PubMedGoogle Scholar
  10. 10.
    Rajkumar T, Soumittra N, Nancy NK et al (2003) BRCA1, BRCA2 and CHEK2 (1100 del C) germline mutations in hereditary breast and ovarian cancer families in South India. Asian Pac J Cancer Prev 4:203–208PubMedGoogle Scholar
  11. 11.
    Valarmathi MT, Sawhney M, Deo SS et al (2004) Novel germline mutations in the BRCA1 and BRCA2 genes in Indian breast and breast-ovarian cancer families. Hum Mutat 23:205PubMedCrossRefGoogle Scholar
  12. 12.
    Nair MK, Sankaranarayanan R, Nair KS et al (1993) Overall survival from breast cancer in Kerala, India, in relation to menstrual, reproductive, and clinical factors. Cancer 71:1791–1796PubMedCrossRefGoogle Scholar
  13. 13.
    Dinshaw KA, Budrukkar AN, Chinoy RF et al (2005) Profile of prognostic factors in 1022 Indian women with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 63:1132–1141PubMedGoogle Scholar
  14. 14.
    Raina V, Bhutani M, Bedi R et al (2005) Clinical features and prognostic factors of early breast cancer at a major cancer center in North India. Indian J Cancer 42:40–45PubMedCrossRefGoogle Scholar
  15. 15.
    Desai SB, Moonim MT, Gill AK et al (2000) Hormone receptor status of breast cancer in India: a study of 798 tumors. Breast 9:267–270PubMedCrossRefGoogle Scholar
  16. 16.
    Mittra I (1994) Breast screening: the case for physical examination without mammography. Lancet 343:342–344PubMedCrossRefGoogle Scholar
  17. 17.
    Tewari M, Pradhan S, Kumar M et al (2006) Effect of prevailing local treatment options of breast cancer on survival outside controlled clinical trials: experience of a specialist breast unit in North India. World J Surg 30:1794–1801PubMedCrossRefGoogle Scholar
  18. 18.
    Kuraparthy S, Reddy KM, Yadagiri LA et al (2007) Epidemiology and patterns of care for invasive breast carcinoma at a community hospital in Southern India. World J Surg Oncol 5:56PubMedCrossRefGoogle Scholar
  19. 19.
    Gajalakshmi CK, Shanta V, Swaminathan R et al (1997) A population-based survival study on female breast cancer in Madras, India. Br J Cancer 75:771–775PubMedGoogle Scholar
  20. 20.
    The World Factbook-2007. Central Intelligence Agency, 2008. Skyhorse Publishing, New YorkGoogle Scholar
  21. 21.
    Tirado-Gómez L, Mohar A (2007) Epidemiología de las neoplasias hemato-oncológicas. Cancerología 2:109–120Google Scholar
  22. 22.
    Cuevas L, Rivera JA (2007) In: Estado Nutricio en Shamah T, Villalpando S, Rivera JA (eds) Resultados de Nutrición de la Encuesta Nacional de Salud Nutricional. Instituto Nacional de Salud Pública, pp 23–83Google Scholar
  23. 23.
    Rodríguez-Cuevas S, Macías CG, Franceschi D et al (2001) Breast carcinoma presents a decade earlier in Mexican women than in women in the United States or European countries. Cancer 91:863–868PubMedCrossRefGoogle Scholar
  24. 24.
    Romieu I, Lazcano-Ponce E, Sanchez-Zamorano LM et al (2004) Carbohydrates and the risk of breast cancer among Mexican women. Cancer Epidemiol Biomarkers Prev 13:1283–1289PubMedGoogle Scholar
  25. 25.
    Romieu I, Hernández-Avila M, Lazcano-Ponce E et al (2000) Breast cancer, lactation history, and serum organochlorines. Am J Epidemiol 152:363–370PubMedCrossRefGoogle Scholar
  26. 26.
    Lajous M, Lazcano-Ponce E, Hernández-Avila M et al (2006) Folate, vitamin B6, and vitamin B12 initiate and the risk of breast cancer among Mexican women. Cancer Epidemiol Biomarkers Prev 15:443–448PubMedCrossRefGoogle Scholar
  27. 27.
    Secretaría de Salud (ed) (2008). Programa de acción para la prevención y control del cáncer de mama. Centro de Equidad de Género y Salud Reproductiva. MéxicoGoogle Scholar
  28. 28.
    Secretaría de Salud. Norma Oficial Mexicana NOM-158-SSA1-1996, para salud ambiental. Especificaciones técnicas para equipos de diagnóstico médico con rayos X Mexico (1994)Google Scholar
  29. 29.
    Secretaría de Salud. Norma Oficial Mexicana NOM-041-SSA2-2002 para la prevención, diagnóstico, tratamiento, control y vigilancia epidemiológica del cancer de mama (2003) MexicoGoogle Scholar
  30. 30.
    Velásquez A (2008) Propuesta centros de lectura de mastografía. Secretaría de Salud, México. http://www.cenetec.salud.gob.mx/descargas/comite_e-Salud/Mamografia2daJunta_modcomite.pdf
  31. 31.
    Gobierno del Distrito Federal (2008) Programa de detección oportuna de cáncer de mama. MéxicoGoogle Scholar
  32. 32.
    Bogdanović S, Margaritoni M, Šoša I (1991) Our experiences in breast conserving surgery (1991) Libri Oncol 20(suppl.1):21Google Scholar
  33. 33.
    Margaritoni M, Margaritoni M Jr (1997) Breast cancer self-detection—manual for every women. Nakladni zavod Globus (editor). Zagreb 9–62Google Scholar
  34. 34.
    Margaritoni M. Breast cancer (1996) Nakladni azvod Globus, ed. Breast Cancer–Diagnosis, Treatment, Detection. Proceedings of Postgraduate Course (1996) in Prizma (editor). Dubrovnik 97–104Google Scholar
  35. 35.
    Margaritoni M, Margaritoni M Jr (1998) The efficiency of information about breast self-examination. Battle Against Cancer 29/30(1):54–61Google Scholar
  36. 36.
    Baker LH. BCDDP: Five-Year Summary Report (1982) Ca—A Cancer Journal for Clinicians 32:194–225Google Scholar
  37. 37.
    Early Breast Cancer Detection (2003) Ministry of Health Republic of Croatia. Zagreb 21–37Google Scholar

Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Gaurav Agarwal
    • 1
  • Pooja Ramakant
    • 1
  • Ernesto R. Sánchez Forgach
    • 2
  • Jorge Carrasco Rendón
    • 2
  • Juan Manuel Chaparro
    • 3
  • Carlos Sánchez Basurto
    • 2
  • Marko Margaritoni
    • 4
  1. 1.Department of Endocrine and Breast SurgerySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  2. 2.Centro de Estudios Mastológicos (Center for Research and Treatment of Breast Diseases-Mastológica Lomas)México CityMéxico
  3. 3.Department of SurgeryABC Medical CenterMéxico CityMexico
  4. 4.Division of Plastic and Breast Surgery, Department of SurgeryCounty Hospital Dubrovnik, University of DubrovnikDubrovnikCroatia

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