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低资源国家(LRCs)的乳腺癌管理:来自乳腺健康全球倡议的共识声明。

Breast cancer management in low resource countries (LRCs): consensus statement from the Breast Health Global Initiative.

机构信息

Breast Cancer Center of Excellence, NK Basile Cancer Institute, American University of Beirut, Beirut, Lebanon.

出版信息

Breast. 2011 Apr;20 Suppl 2:S3-11. doi: 10.1016/j.breast.2011.02.006.

Abstract

The Breast Health Global Initiative (BHGI) brought together international breast cancer experts to discuss breast cancer in low resource countries (LRCs) and identify common concerns reviewed in this consensus statement. There continues to be a lack of public and health care professionals' awareness of the importance of early detection of breast cancer. Mastectomy continues to be the most common treatment for breast cancer; and a lack of surgeons and anesthesia services was identified as a contributing factor in delayed surgical therapy in LRCs. Where available, radiation therapy is still more likely to be used for palliation rather than for curative treatment. Tumor receptor status is often suboptimally performed due to lack of advanced pathology services and variable quality control of tissue handling and processing. Regional pathology services can be a cost-effective approach and can serve as reference, training and research centers. Limited availability of medical oncologists in LRCs often results in non-specialist providing chemotherapeutic services, which requires additional supervision and training. Palliative care is an emerging field in LRCs that requires investment in training and infrastructure development. A commitment and investment in the development of breast cancer care services by LRC governments and health authorities remains a critical need in LRCs.

摘要

乳腺健康全球倡议(BHGI)召集了国际乳腺癌专家,讨论资源匮乏国家(LRC)的乳腺癌问题,并确定了本共识声明中审查的共同关注点。公众和医疗保健专业人员对早期发现乳腺癌重要性的认识仍然不足。乳房切除术仍然是乳腺癌最常见的治疗方法;在 LRC 中,外科医生和麻醉服务的缺乏被认为是导致手术治疗延迟的一个因素。在有条件的情况下,放疗仍然更有可能用于缓解症状,而不是治疗。由于缺乏先进的病理学服务以及组织处理和加工的质量控制存在差异,肿瘤受体状态的检测往往不理想。区域病理学服务可以是一种具有成本效益的方法,并可以作为参考、培训和研究中心。LRC 中医学肿瘤学家的数量有限,往往导致非专科医生提供化疗服务,这需要额外的监督和培训。姑息治疗是 LRC 中的一个新兴领域,需要在培训和基础设施发展方面进行投资。LRC 政府和卫生当局承诺并投资于乳腺癌护理服务的发展,这在 LRC 仍然是一个关键需求。

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