Breast cancer: prevention and control

Introduction
Breast cancer is the top cancer in women both in the developed and the developing world. The incidence of breast cancer is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles. Although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where breast cancer is diagnosed in very late stages. Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control.
The recommended early detection strategies for low- and middle-income countries are awareness of early signs and symptoms and screening by clinical breast examination in demonstration areas. Mammography screening is very costly and is recommended for countries with good health infrastructure that can afford a long-term programme.
Many low- and middle-income countries that face the double burden of cervical and breast cancer need to implement combined cost-effective and affordable interventions to tackle these highly preventable diseases.
WHO promotes breast cancer control within the context of national cancer control programmes and integrated to noncommunicable disease prevention and control. WHO, with the support of Komen Foundation, is at present conducting a 5-year breast cancer cost-effectiveness study in 10 low- and middle-income countries. The project includes a programme costing tool to assess affordability. It is expected that the results of this project will contribute to provide evidence for shaping adequate breast cancer policies in less developed countries.