The Breast Health Global Initiative: why it matters to all of us.

The Breast Health Global Initiative (BHGI) applied an evidence-based consensus review process to the development of guidelines for breast cancer early detection, diagnosis, treatment and health care systems in low- and middle-income countries (LMCs). Breast cancer outcomes correlate with the degree to which (1) cancers are detected at early stages, (2) newly detected cancers can be diagnosed correctly, and (3) appropriately selected multimodality treatment can be provided properly and in a timely fashion. Cancer prevention through health behavior modification may influence breast cancer incidence in LMCs, although prevention strategies alone cannot eliminate the great majority of breast cancer cases. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality, assuming that appropriate multimodality treatment is provided. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important steps in early detection. Obstacles to breast cancer early detection, diagnosis, and treatment occur in industrialized countries as well as LMCs. Understanding implementation in LMCs can inform policy makers in the U.S. on how to improve health care delivery in underserved communities, where the challenges mirror those of low-resource environments.