Breast cancer is the most common cancer reported in women worldwide and in developing nations, the latter where it is characterized by occurrence at younger ages. In Zambia and most other countries in sub-Saharan Africa, breast cancer is the second most common cancer diagnosed in women, after cancer of the cervix. Breast cancer incidence is on the increase in developing nations, where a lack of public awareness, absence of organized screening programs, economic/cultural barriers, a severely limited oncology workforce, and an underdeveloped cancer care infrastructure have resulted in women presenting at late stages of the disease with an unacceptably high mortality rate.
The critical components of a breast cancer control strategy in resource-constrained environments are public awareness of the disease and an acceptable, affordable, and appropriate model for downstaging. More specifically, the components include public awareness campaigns led by community-based organizations, clinical breast examinations, ultrasound, and ultrasound-guided biopsy of palpable masses by nurses/licentiates in primary clinics. Such intervention strategies must be combined with opportunities for effective treatment. This would necessitate a rigorous training program in performing clinical breast examination, diagnostic ultrasound examinations and interpretation of pathology results. Surgeons will need to be trained in modern methods of treatment and an efficient referral system will need to be established.
In Zambia, in accordance with the government’s National Health Plan to reduce breast cancer mortality rates, the centre will work with community-based cancer advocacy groups and UTH oncologists, surgeons, pathologists, and radiographers to develop an appropriate breast cancer awareness and early detection strategy and infrastructure that will build on the experiences and clinical platform of the Cervical Cancer Prevention Program in Zambia and the Cancer Diseases Hospital.