The annual cancer statistics released in January 2020 by the American Cancer Society reaffirm the progress we’re making in the fight against breast cancer in the U.S. Thanks in large part to improvements in early detection and early and effective treatments, the mortality rate for breast cancer in the U.S. has decreased by 40 percent since 1989. Unfortunately, this success has not been equally shared across the world. In many developing countries, access to early diagnosis and treatment is low, and as a result, breast cancers are more often detected later, making treatment more difficult and less successful.
Efforts are underway to change that. For example, national guidelines for the early diagnosis of breast cancer in Zambia announced in February seek to reduce the current number of breast cancer deaths in that country by 25 percent by 2025. The goal is part of the National Cancer Control Strategic Plan set by the Zambian Ministry of Health.
The national guidelines are part of a years-long project led by Susan G. Komen, in conjunction with stakeholders from different organizations, to reduce the number of people who develop breast cancer and die from it. Komen’s collaboration with the Zambian Ministry of Health started in 2011. Since then, Komen has collaborated with the Ministry of Health and several local organizations on a number of initiatives, including to develop guidelines for early diagnosis of breast cancer.
By expanding access to breast cancer awareness, early diagnosis, treatment and care, the Ministry of Health hopes that breast cancer will be detected earlier in Zambia. Currently, breast cancer is the most common type of cancer for women in Zambia, and patients typically present with stage III or stage IV breast cancer at the time of diagnosis. Currently, about 40 percent of people in Zambia with breast cancer die from the disease.
Starting immediately, Zambia will implement breast care services and programs for health care providers, provide quality breast cancer services that are affordable and accessible, and encourage health officials to use treatments and therapies that have been proven effective through evaluations.
By educating every Zambian health facility, in both rural and urban communities, about the signs and symptoms of breast cancer, health providers can help overcome misconceptions, fears and the social stigma associated with breast cancer. Additional education efforts will focus on helping women to understand their breast health and warning signs. That way members of the community with early warning signs of breast cancer can be connected with health facilities earlier, before breast cancer has progressed to stage III or IV.
Most breast cancer patients in Zambia are under 50 years of age and outcomes after diagnosis are poor. Treatment for stage IV (metastatic breast cancer), for example, is complicated since there is currently no cure for it.
To achieve a 25 percent reduction in breast cancer deaths in the next five years, medical facilities in Zambia will have to increase their efforts to detect breast masses early and refer patients to the necessary level of health care without delay. From there, services including imaging, biopsies and treatment plans will have to be coordinated quickly across the health system.
The national guidelines are a major step toward early diagnosis and successful treatment in Zambia. By educating all health facilities and women about breast health, breast cancer can be identified at the earliest possible opportunity and treatment can begin without delay.