Chair and Director Breast Health Global Initiative Fred Hutchinson Cancer Research Center

www.bhgi.infowww.bhgi.infowww.bhgi.info

Benjamin O. Anderson, M.D.Benjamin O. Anderson, M.D.

www.bhgi.infowww.bhgi.info

BHGI resource-stratified guidelines

Low-income: Ghana, West Africa

Middle-income: Latin America


““Breast cancer REALLY Breast cancer REALLY only only affects countries of wealth.”affects countries of wealth.”

FACT:FACT: Breast cancer is the most common Breast cancer is the most common cancer among women around the globe, cancer among women around the globe, and the most likely reason that a woman and the most likely reason that a woman will die of cancer.will die of cancer.

Ratio:MortalityIncidence

2002: 1,152,000 cases, 411,000 2002: 1,152,000 cases, 411,000

deathsdeaths

Breast cancer in developing countries:Breast cancer in developing countries:514,000 514,000 (45%) (45%) cases; 221,000 cases; 221,000 (55%) (55%) deathsdeaths

Globocan 2002 (IARC)Globocan 2002 (IARC)

ColombiaColombia

2005 2020 2050

Globocan 2002 (IARC) - ColombiaGlobocan 2002 (IARC) - Colombia

Globocan 2002 (IARC) - ColombiaGlobocan 2002 (IARC) - Colombia

STAGE EXTENT5 year

SURVIVAL

DISTRIBUTION

USA INDIA

0 Noninvasive 100% 16% ----

I Early stage disease 100% 40% 1%

II Early stage disease 86% 34% 23%

III Locally advanced 57% 6% 52%

IV Metastatic disease 20% 4% 24%

INDIA:76% locally advanced or metastatic at

diagnosis

Sources: Sources: SEER Survival Monograph (NCI), SEER Survival Monograph (NCI), 2007;2007;

Chopra, Cancer Institute Chennai, India, Chopra, Cancer Institute Chennai, India, 20012001

USA:90% DCIS or early staged

invasive disease at diagnosis


The The Breast Health Global Initiative (BHGI)Breast Health Global Initiative (BHGI) strives strives

to develop, implement and study evidence-to develop, implement and study evidence-

based, economically feasible, and culturally based, economically feasible, and culturally

appropriate guidelines for international breast appropriate guidelines for international breast

health and cancer control for low and middle health and cancer control for low and middle

income countries to improve breast health income countries to improve breast health

outcomes.outcomes.


Cancer: 113 (8 suppl), 2008 Cancer: 113 (8 suppl), 2008

CONSENSUS CONSENSUS STATEMENTSSTATEMENTS

Early DetectionEarly Detection

DiagnosisDiagnosis

TreatmentTreatment

Health Care SystemsHealth Care Systems

8 Stratified Tables8 Stratified Tables

10 Individual 10 Individual ManuscriptsManuscripts

EARLY DETECTION DIAGNOSIS

STAGE I STAGE II LOCALLY ADVANCED METASTATIC

HEALTH CARE SYSTEMS


Dissemination & implementation (D&I) Dissemination & implementation (D&I)

research research

Education and training programs Education and training programs

Technology application and developmentTechnology application and development

IMPLEMENTATION STRATEGY: IMPLEMENTATION STRATEGY: Create Create BHGIBHGI Learning LaboratoriesLearning Laboratories in different in different parts of the world to develop and test parts of the world to develop and test educational modules based on BHGI guidelines educational modules based on BHGI guidelines and to model program expansion to other and to model program expansion to other LMCs.LMCs.

Komfo Anokye Teaching Hospital (KATH) 1,000 bed hospital , Kumasi, Ghana


Advanced cancer at diagnosisAdvanced cancer at diagnosis

Mastectomy without systemic treatmentMastectomy without systemic treatment

One pathologist for 1,000 bed teaching One pathologist for 1,000 bed teaching hospitalhospital

Breast pathology reports take 4 –6 Breast pathology reports take 4 –6 monthsmonths

Awareness

Survivorship

Early Detection

Diagnosis

Treatment

Advocacy

Public ParticipationPublic Participation Health Care DeliveryHealth Care Delivery

LB COLOMBIALB COLOMBIA

LB MEXICOLB MEXICO

LB BRAZILLB BRAZIL

www.bhgi.info

Chair and Director Breast Health Global Initiative Fred Hutchinson Cancer Research Center

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