International Federation of Gynecology and Obstetrics

FIGOBREASTWORKINGGROUP

DR.SVENBECKER- GERMANYDR.NESTORGARELLO- ARGENTINIADR.WADIHGHANAME– LEBANONDR.MINORUIRAHARA– JAPAN

DR.SIBONEMOCUMBI– MOZAMBIQUEDR.MARKPEARLMAN– USADR.TARINITANEJA– INDIA

DR.GUSTAVOFERREIRODELGADO- URUGUAY

FIGOBREASTWORKINGGROUP

ESTABLISHED2015

IMPROVINGWOMEN’SACCESSTOBREASTHEALTHANDBREASTCANCERSCREENINGANDTREATMENT

BREASTCANCER– THENEXTGLOBALHEALTHCHALLENGE

Already, BreastCancer is thenumber onefemalecancer

Early diagnosis and adequate treatment make it a highlycurable cancer!

American Cancer Society

Incidenceremains highestin High Ressource Countries – but the gap isgetting smaller!

American Cancer Society

Screening, Early Diagnosis and AdequateTreatment can save thousands of lifes

Risc factor Change of breast cancer riskAge at first childbirth + 3 % per yearNumber of births - 7 % per birthBreast feeding - 4,3 % per year breast feedingAge of menopause + 3 % per yearAge of menarche - 4 % per yearBody weight at postmenopause + 1 % per kg weightBody size + 1 % per cmSmoking premenopausal + 3 % per year

Because of changing risk factors – the trends will continue in all emerging economies

TreatmentQualityMatters:GuidelineViolationversusnone

Kum

ulie

rte Ü

berle

bens

rate

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

Guideline conform therapyOne undertherapytwo undertherapiesthree undertherapies

Overal survival in years

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14

GermanSocietyof Obstetrics and Gynecology

Five Key Issues

#1 Awareness – Screening + Early Diagnosis save lifes + breasts#2 Interdisciplinarity – Teaching the right techniques to the right people#3 How to adapt strategies to different resource settings? #4 Breast Cancer does not mean Loss of Breast! #5 How to make medication available to all patients

#1 Issue: Awareness – Screening and Early Diagnosis save lifes and breasts

AWARENESFORBREASTHEALTHANDBREASTCANCER

WOMEN’SDISEASESREMAINTABOO-TOPICSINMANYCOUNTRIES

GOAL:TOCONVINCELOCALPOLITICIANSANDLOCALMEDIATODEVOTETIMEANDMEDIAATTENTIONTOTHETOPICOFBREAST

DISEASE

AWARENESSANDKNOWLEDGEABOUTTREATMENTOPTIONSWILLPAVETHEWAYTOSCREENINGANDEARLYDIAGNOSIS

#2 Issue: Interdisciplinarity – Teaching theright techniques to the rightpeople

BREASTCANCERNEEDSTOBETREATEDBYGYNECOLOGISTS,SURGEONS,RADIOLOGISTS,PATHOLOGISTS,MEDICALONCOLOGISTS,

RADIATIONONCOLOGISTS

CREATINGINTERDISCIPLINARYTEAMSISKEYTOESTABLISHINGBREASTTREATMENTCENTERS

#3 Issue: How to adapt strategies todifferent ressource settings?

Diagnostics Surgery Systemic Radiation

BREASTCANCERTREATMENTCANBEBASIC– LUMPECTOMY

BREASTCANCERTREATMENTCANBEHIGHEND– IMPLANT-SURGERYANDTARGETEDTHERAPY

TREATMENTSTRATEGIESMUSTBEADOPTEDTOSERVEWOMENINDIFFERENTRESSOURCESETTINGS

#4 Issue: Breast Cancer does not mean Loss of Breast!

ONLYWHENWOMENUNDERSTANDTHATBREASTCONVERSATIONISSTANDARDWILLTHEFEAROFBREAST

CANCERDISAPPEAR

Minimal-Invasion – Minimal Trauma – Breast Conserving Surgerycan cure up to 70% of breast cancer

Becker, Wallwiener et al. 2009

Tamoxifen AnastrozolLetrozolExemestan

TrastuzumabPertuzumabTrastuzumab emtansineLapatinib

BevacicumabEverolimus

PalbociclibOlaparib

EpirubicinDoxorubicinCyclophosphamidPaclitaxelDocetaxolCapecitabineVinorelbinEribulinPLDNab-PaclitaxelGemcitabine

ZoledronatBondronatDenosumab

#5 IssueHow to makemedicationavailable to all patients

ONCEBREASTCANCERISANACCEPTEDISSUECANRESSOURCESBEREDIRECTED

FIGOBREASEWORKINGGROUP

ACTIONPLAN

FIGOBREASEWORKINGGROUP- ACTIONPLAN

1)CREATEFIGORESSOURCE-MATERIAL2)CREATELOCALPROJECTS(BYWORKINGGROUPMEMBERS)TOTESTFIVE-ISSUE-MOTION3)TEAMUPWITHOTHERGROUPS(BHGI– SUSANKOMEN)4)CREATEBREASTCONFERENCESINLOW/MEDIUMRESSOURCECOUNTRIES5)MAKE“BREAST”AREGULARTOPICINFIGOCONFERENCES6)MAKE“LOW/MEDIUM– RESSOURCEBREASTCARE”ATOPICATALLINTERNATIONALBREASTCONFERENCES7)EVALUATEECONOMICHEALTHIMPACTOFEARLYBREASTCANCERCARE8)CREATESCREENINGCONCEPTSFORLOW/MEDIUMRESSOURCECOUNTRIES9)CREATETREATMENTCONCEPTSFORLOW/MEDIUMRESSOURCECOUNTRIES10)INVOLVEPHARMACEUTICALCOMPANIES