Improving Healthcare Services for Women with Breast Cancer
Breast cancer is the most common cancer worldwide and the leading cause of cancer death among women, especially in low- and middle-income countries (LMICs) . Despite the availability of effective interventions for prevention, early detection, diagnosis, treatment and palliative care, many women with breast cancer face barriers to access quality services and experience poor outcomes . Improving healthcare services for women with breast cancer requires a comprehensive and coordinated approach that addresses the needs of patients across the continuum of care .
Health promotion and early detection
Health promotion and early detection are essential strategies to reduce the burden of breast cancer and improve survival. Health promotion aims to raise awareness of breast cancer risk factors, such as obesity, alcohol use, tobacco use and hormone therapy, and promote healthy behaviours, such as physical activity, breastfeeding and avoiding exposure to carcinogens . Health promotion also empowers women to seek care when they notice any changes in their breasts, such as lumps, pain, discharge or skin changes .
Early detection refers to the timely identification of breast cancer before it causes symptoms or spreads to other parts of the body. Early detection can be achieved through screening or clinical examination. Screening is the systematic application of a test to a defined population of asymptomatic women to identify those who may have breast cancer and refer them for further investigation . Screening can be done using mammography, which is an X-ray examination of the breasts, or ultrasound, which uses sound waves to create images of the breasts. Clinical examination is the physical inspection and palpation of the breasts by a trained health worker .
Both screening and clinical examination can reduce breast cancer mortality by detecting cancers at an earlier stage, when they are more likely to be treated successfully . However, screening and clinical examination have different advantages and disadvantages in terms of accuracy, cost, feasibility and acceptability. Therefore, the choice of the best method depends on the availability of resources, the epidemiology of breast cancer and the preferences of women and health authorities .
Timely diagnosis is the confirmation of breast cancer through histopathological examination of a tissue sample obtained by biopsy or fine needle aspiration . Timely diagnosis is crucial to ensure that women with breast cancer receive appropriate treatment and care without delay. Delayed diagnosis can lead to advanced disease, lower chances of survival, higher costs of treatment and lower quality of life .
The main challenges to timely diagnosis include lack of awareness, stigma, fear, denial, cost, distance, waiting time, shortage of trained staff, equipment and supplies, and poor referral systems . To overcome these challenges, WHO recommends a three-step approach for timely diagnosis: improving access to primary care services; strengthening diagnostic capacity at secondary care level; and ensuring effective referral and feedback mechanisms between primary and secondary care .
Comprehensive treatment and supportive care
Comprehensive treatment and supportive care are the provision of evidence-based interventions to cure or control breast cancer and improve the physical, emotional and social well-being of patients and their families . Comprehensive treatment and supportive care include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, pain relief, palliative care, psychosocial support and rehabilitation .
The choice of treatment depends on several factors, such as the type, stage and molecular characteristics of the breast cancer; the availability of resources; the preferences of the patient; and the presence of comorbidities . The goal of treatment is to remove or destroy the cancer cells while preserving as much normal breast tissue as possible. Surgery is usually the first option for most women with early or locally advanced breast cancer. Radiation therapy is often given after surgery to reduce the risk of recurrence. Chemotherapy, hormone therapy or targeted therapy are used to treat systemic disease or prevent metastasis. Immunotherapy is a newer option for some types of breast cancer that stimulate the immune system to fight the cancer cells .
Supportive care is an integral part of comprehensive treatment that aims to improve the quality of life of patients and their families by addressing their physical, psychological, social and spiritual needs. Supportive care includes pain relief, palliative care, psychosocial support and rehabilitation. Pain relief is essential to alleviate suffering and improve function. Palliative care is specialized care that focuses on symptom management, communication and decision making for patients with life-threatening illnesses. Psychosocial support is counselling or therapy that helps patients cope with emotional distress, anxiety or depression. Rehabilitation is a process that helps patients restore their physical abilities and social roles after treatment .
Breast cancer is a major public health problem that affects millions of women around the world. Improving healthcare services for women with breast cancer requires a comprehensive and coordinated approach that covers health promotion, early detection, timely diagnosis, comprehensive treatment and supportive care. By implementing these strategies, countries can reduce the burden of breast cancer and improve the survival and quality of life of women with this disease.
: World Health Organization. Breast cancer. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer
: World Health Organization. The Global Breast Cancer Initiative assignment help – research paper writing service USA. 2023. Available from: https://www.who.int/initiatives/global-breast-cancer-initiative
: National Institute for Health and Care Excellence. Improving outcomes in breast cancer. 2002. Available from: https://www.nice.org.uk/guidance/csg1
: World Health Organization. New global breast cancer initiative highlights renewed commitment to improve survival. 2021. Available from: https://www.who.int/news/item/08-03-2021-new-global-breast-cancer-initiative-highlights-renewed-commitment-to-improve-survival
: Nevada Department of Health and Human Services. Women’s Health Connection (WHC). Available from: https://dpbh.nv.gov/Programs/WHC/Women_s_Health_Connection_-_Home/