Komen grant: Support for global guidelines

The Susan G. Komen Breast Cancer Foundation has awarded $500,000 to support the Center's Breast Health Global Initiative (BHGI), a program dedicated to medically underserved women around the world. The funds will enable BHGI to further its international initiatives in breast-cancer early detection, treatment and public-health-care policy.

Founded and led by the Center and the Komen Foundation, BHGI is a global public-health alliance comprised of world and regional health organizations, governmental agencies and health ministries, nongovernmental organizations, nonprofit and for-profit organizations, physicians, scientists, health-care providers and advocates.

"Historically there has been little attention paid — and few funds available — toward the cause of women with chronic disease living in countries with limited health-care resources," said Dr. Benjamin Anderson, principal investigator, chairman and director of BHGI, and a Seattle Cancer Care Alliance physician. "We are tremendously grateful to the Komen Foundation for its vision in providing essential funding that will support international pilot research and demonstration projects."

BHGI, which strives to define breast-health guidelines that are evidence-based, culturally appropriate and economically stratified, recently published "Guidelines for International Breast Health and Cancer Control." The guidelines, which appear as a 122-page supplement in the January-February 2006 issue of The Breast Journal, set the stage to reduce the burdens of breast cancer in developing nations.

The guidelines expand and refine those first published in 2003 to help developing nations find ways to make economically feasible and culturally appropriate care available to medically underserved women. The new publication proposes an economically stratified approach to providing breast care based on available health-care resources, and a checklist format.

Recommendations are outlined for breast health and cancer control in limited-resource countries in four areas: early detection and access to care, diagnosis and pathology, treatment and allocation of resources, and health-care systems and public policy. Based on each country's resources, the guidelines recommend a level of service or care and evaluation goals. Four panels of BHGI international experts from 33 countries with a wide range of resource levels developed the guideline recommendations using an evidence-based consensus approach.

According to Anderson, breast-cancer incidence rates have been increasing by up to 5 percent a year in some medium- and low-resource regions. Women in those regions tend to be diagnosed with breast cancer that is already locally advanced or metastatic. The Komen grant will enable BHGI to conduct pilot research and demonstration projects to further validate and expand upon future iterations of guidelines.

Projects may involve testing diagnostic technologies and assessment of breast-cancer systems and situations in medium — and low — level resource countries to provide essential information and recommendations to shape national strategies for early detection and cancer treatment. These projects will result in much-needed data to set strategies for those countries to improve health-care services.

"The scarcity of breast-cancer research and data in countries of limited health-care resources is a significant obstacle to improving care," said Andrew Halpern, vice president and general counsel of the Susan G. Komen Breast Cancer Foundation. "The work of BHGI will generate much-needed data to address critical disparities in international breast-cancer control."

Breast-cancer statistics

Every year, more than 1 million women worldwide are diagnosed with breast cancer; those cases represent more than 10 percent of all new cancer cases. More than 410,000 women die from breast cancer each year, making breast cancer the most common cause of cancer-related death among women around the world, according to the International Agency for Research on Cancer.