Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Table 1 Recommendations for breast cancer screening/early detection and public education/awareness according to the resource level of a country[46]

Level of resources	Public education and awareness	Detection methods	Evaluation goal
Basic	Developing culturally sensitive and linguistically appropriate local education programs for target populations to convey value of early detection, BC risk factors and breast health awareness (education and self examination)	Clinical history and CBEs	Breast health awareness regarding value of early detection in improving BC outcome
Limited	Culturally and linguistically appropriate targeted outreach/education encouraging CBE for age groups at higher risk administered at district level using healthcare provider in the field	Diagnostic breast USG and/or diagnostic mammography if CBE + Mammographic screening of high risk target groups	Downsizing of symptomatic disease
Enhanced	Regional awareness programs regarding breast health related to general health and women’s health programs	Mammographic screening every 2 yr in women aged 50 or older Consider mammographic screening (or USG) every 12-18 mo in women aged 40-49	Downsizing and/or downstaging of asymptomatic disease in highest yield target groups
Maximal	National awareness campaigns regarding breast health using mass media	Annual mammographic screening in women aged 40 or more	Downsizing and/or downstaging of asymptomatic disease in women in all risk groups

CBE: Clinical breast examination; USG: Ultrasonography; BC: Breast cancer.