Early detection and treatment strategies for breast cancer in low-income and upper middle-income countries: a modelling study

The Lancet Global Health
Jeanette BirnbaumRuth Etzioni

Abstract

Poor breast cancer survival in low-income and middle-income countries (LMICs) can be attributed to advanced-stage presentation and poor access to systemic therapy. We aimed to estimate the outcomes of different early detection strategies in combination with systemic chemotherapy and endocrine therapy in LMICs. We adapted a microsimulation model to project outcomes of three early detection strategies alone or in combination with three systemic treatment programmes beyond standard of care (programme A): programme B was endocrine therapy for all oestrogen-receptor (ER)-positive cases; programme C was programme B plus chemotherapy for ER-negative cases; programme D was programme C plus chemotherapy for advanced ER-positive cases. The main outcomes were reductions in breast cancer-related mortality and lives saved per 100 000 women relative to the standard of care for women aged 30-49 years in a low-income setting (East Africa; using incidence data and life tables from Uganda and data on tumour characteristics from various East African countries) and for women aged 50-69 years in a middle-income setting (Colombia). In the East African setting, relative mortality reductions were 8-41%, corresponding to 23 (95% uncertainty interval -1...Continue Reading

Citations

Aug 28, 2019·Journal of Global Oncology·Rupali SoodSusan C Harvey
Mar 13, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Shifali BansalChaitra Gopalappa
Apr 30, 2020·Cancer·Catherine DugganBenjamin O Anderson
Sep 1, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·William T TranBelinda Curpen
Oct 26, 2018·The New England Journal of Medicine·Rowan T Chlebowski, Kathy Pan
Jun 7, 2021·Gynécologie, Obstétrique, Fertilité & Sénologie·Z Al MasryC Devalland
Aug 23, 2020·The Lancet Global Health·Valerie McCormackIsabel Dos-Santos-Silva

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