Guideline implementation for breast healthcare in low-income and middle-income countries

摘要: 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 can be diagnosed correctly, 3) appropriately selected multimodality treatment provided properly a timely fashion. The Health Global Initiative (BHGI) invited international experts review revise previously developed BHGI resource-stratified guideline tables for detection, diagnosis, treatment, healthcare systems. Focus groups addressed specific issues breast pathology, radiation therapy, management of locally advanced disease. Process metrics were based on priorities established stratification. indicated that prevention through health behavior modification could influence incidence LMCs. Diagnosing earlier stages will reduce mortality. Programs promote self-awareness clinical examination resource-adapted mammographic screening important detection steps. imaging, initially ultrasound and, higher resource levels diagnostic mammography, improves preoperative assessment permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, systemic therapies. Government intervention is needed address drug-delivery problems relating high cost poor access. Guideline dissemination implementation research plays crucial role improving care. Adaptation technology LMCs, especially treatment. Curricula education training LMCs should developed, applied, studied LMC-based learning laboratories aid information transfer evidence-based guidelines.