Breast cancer: prevention and control
Breast cancer is the top cancer in women both in the developed and the developing world. The incidence of breast cancer is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles. Although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where breast cancer is diagnosed in very late stages. Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control.
Limited resource settings with weak health systems where breast cancer incidence is relatively low and the majority of women are diagnosed in late stages have the option to implement early diagnosis programmes based on awareness of early signs and symptoms and prompt referral to diagnosis and treatment.
Population-based cancer screening is a much more complex public health undertaking than early diagnosis and is usually cost-effective when done in the context of high-standard programmes that target all the population at risk in a given geographical area with high specific cancer burden, with everyone who takes part being offered the same level of screening, diagnosis and treatment services.
So far the only breast cancer screening method that has proved to be effective is mammography screening. Mammography screening is very costly and is cost-effective and feasible in countries with good health infrastructure that can afford a long-term organized population-based screening programmes. Low-cost screening approaches, such as clinical breast examination, could be implemented in limited resource settings when the necessary evidence from ongoing studies becomes available.
Many low- and middle-income countries that face the double burden of cervical and breast cancer need to implement combined cost-effective and affordable interventions to tackle these highly preventable diseases.
WHO promotes breast cancer control within the context of national cancer control programmes and integrated to noncommunicable disease prevention and control.
Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control.