Breast Health Global Initiative: Guidelines for International
Breast Health and Cancer Control
The Breast
Health Global Initiative’s mission is develop,
implement and study evidence-based, economically feasible,
and culturally appropriate Guidelines for International
Breast Health and Cancer Control for low- and middle-income
countries (LMCs) to improve breast health outcomes and
access to breast cancer screening, detection and treatment
for women.
2008 new Guidelines for International Breast Health
and Cancer Control-Implementation were published as special
supplement of the Oct. 15, 2008 journal Cancer. Detailing
for the first time guidelines for low- and middle-income
countries on how to implement breast cancer programs
to detect and treat the most common disease among women
worldwide. Other articles address breast pathology, radiation
treatment, surgery and treatment of locally-advanced
cancer. Such and other publications can be found in the
“guidelines” section below as pdf files for easy download.
What do we know about
diet and breast cancer?
The
Panel of WCRF/AICRconcludes in Chapter 7.10, pages
289-295 (to download the chapter 7 pages, pdf220K, click
here)
The evidence that lactation protects
against breast cancer at all ages thereafter is convincing.
Physical activity probably protects against postmenopausal
breast cancer, and there is limited evidence suggesting
that it protects against premenopausal breast cancer.
The evidence that alcoholic drinks are a cause of breast
cancer at all ages is convincing. The evidence that the
factors that lead to greater attained adult height or
its consequences are a cause of postmenopausal breast
cancer is convincing; these are probably a cause of premenopausal
breast cancer.
The factors that lead to greater
birth weight or its consequences are probably a cause
of breast cancer diagnosed premenopause. Adult weight
gain is probably a cause of postmenopausal breast cancer.
The evidence that body fatness is a cause of postmenopausal
breast cancer is convincing, and abdominal body fatness
is probably a cause of this cancer. On the other hand,
body fatness probably protects against breast cancer
diagnosed premenopause. There is limited evidence suggesting
that total dietary fat is a cause of postmenopausal breast
cancer.
Source: Second Expert Report:
Food, Nutrition, Physical Activity, and the Prevention
of Cancer: a Global Perspective. World Cancer
Research Fund / American Institute for Cancer Research
(WCRF/AICR), Washington DC: AICR, 2007. 537 Pages.
Note: PDF file of the complete report is 12 MB in size.
More about this report can be found on the “diet” link
[or some other name later] of this website. To download
the entire report (pdf 12MB) please
click here.
To download a summary of the report (16 pages, pdf 1.2MB) please
click here To download the report’s summary
in other languages than English (WCRF website), please
click here
MedlinePlus
- Breast Cancer Link
MedlinePlus will direct you to information to help answer health questions. MedlinePlus
brings together authoritative information from NLM, the National Institutes of
Health (NIH), and other government agencies and health-related organizations.
MedlinePlus also has extensive information about drugs, an illustrated medical
encyclopedia, interactive patient tutorials, and latest health news. Please make
sure you check the MedlinePlus online for breast cancer with an extensive, constantly
updated resource list. Please
click here
The Breast Health Global Initiative
(BHGI) strives to develop, implement and study evidence-based,
economically feasible, and culturally appropriate "Guidelines
for International Breast Health and Cancer Control" for
low- and middle-income countries to improve breast health
outcomes.
2008 Guidelines
for International Breast Health and Cancer Control
Implementation
Published in Cancer, Volume 113 Issue Supplement
8 , Pages 2215 - 2371 (15 October 2008)
A Supplement to CANCER, developed by the Breast
Health Global Initiative
Supplement: Introduction
(p 2215-2216)
Benjamin O. Anderson, Sandra R. Distelhorst. To download
the pdf click
here
A time for creative collaboration
Gabriel N. Hortobágyi, MD, Department of Breast Medical
Oncology, The University of Texas M. D. Anderson Cancer
Center, Houston, Texas. Cancer, Volume 113 Issue S8,
Pages 2217 – 2220. 4 pages (pdf 100K).To download the
pdf please
click here.
Defining a global research
agenda for breast cancer (p 2366-2371)
Richard R. Love. 6 pages (pdf 88K). To download the pdf please
click here.
Guideline implementation
for breast healthcare in low-income and middle-income
countries : Overview of the Breast Health Global Initiative
Global Summit 2007 (p 2221-2243)
Benjamin O. Anderson, Cheng-Har Yip, Robert A. et al.
23 pages (pdf 1.9MB)
Guideline dissemination and implementation
research plays a crucial role in improving care, and
adaptation of technology is needed in low- and middle-income
countries (LMCs), especially for breast imaging, pathology,
radiation therapy, and systemic treatment. Curricula
for education and training in LMCs should be developed,
applied, and studied in LMC-based learning laboratories
to aid information transfer of evidence-based Breast
Health Global Initiative guidelines. To download the
pdf please
click here
Guideline implementation
for breast healthcare in low- and middle-income countries:
Early detection resource allocation (p 2244-2256)
Cheng-Har Yip, Robert A. Smith, Benjamin O. Anderson,
et al, on behalf of the Breast Health Global Initiative
Early Detection Panel. 13 pages (pdf 500K). To download
the pdf please
click here.
Guideline implementation
for breast healthcare in low- and middle-income countries:
Diagnosis resource allocation (p 2257-2268)
Roman Shyyan, Stephen F. Sener, Benjamin O. Anderson,
et al, on behalf of the Breast Health Global Initiative
Diagnosis Panel
12 pages (pdf 309K). To download the pdf please
click here.
Guideline implementation
for breast healthcare in low- and middle-Income countries:
Treatment resource allocation (p 2269-2281)
Alexandru Eniu, Robert W. Carlson, Nagi S. El Saghir,
Jose Bines, et al.
13 pages (pdf 1MB). To download the pdf please
click here.
Guideline implementation
for breast healthcare in low- and middle-income countries:
Breast healthcare program resource allocation (p 2282-2296)
Joe Harford, Edward Azavedo, Mary Fischietto
15 pages (pdf 900K). To download the pdf please
click here.
Breast pathology guideline
implementation in low- and middle-income countries
(p 2297-2304)
Shahla Masood, László Vass, Julio A. Ibarra Jr wt al.
8 pages (pdf 100K). To download the pdf
please click here.
The quality of breast healthcare and the ultimate clinical
outcome of patients with breast cancer are directly related
to the quality of breast pathology practice. Proper training
in breast pathology for pathologists and laboratory technicians
is critical and provides the underpinnings of programmatic
success for any country at any level of economic wealth.
Breast radiation therapy
guideline implementation in low- and middle-income
countries (p 2305-2314)
Nuran Senel Bese, Anusheel Munshi, Ashwini Budrukkar,
Ahmed Elzawawy, Carlos A. Perez, on behalf of the Breast
Health Global Initiative Radiation Therapy Focus Group
10 pages (pdf 128K). To download the pdf please
click here.
Locally advanced breast cancer:
Treatment guideline implementation with particular
attention to low- and middle-income countries (p 2315-2324)
Nagi S. El Saghir, Alexandru Eniu, Robert W. Carlson,
Zeba Aziz, Daniel Vorobiof, Gabriel N. Hortobagyi, on
behalf of the Breast Health Global Initiative Systemic
Therapy Focus Group
13 pages (pdf 119K). To download the pdf please
click here.
Breast cancer prevention
in countries with diverse resources (p 2325-2330)
Anne McTiernan, Peggy Porter, John D. Potter
6 pages (pdf 88K). To download the pdf please
click here.
Strategic health communication
across the continuum of breast cancer care in limited-resource
countries (p 2331-2337)
Gary L. Kreps, Rama Sivaram. 13 pages (pdf 1MB). To download
the pdf please
click here.
Re-establishing a surgical
pathology service in Kumasi, Ghana : Case report and
discussion of barriers and key elements of a successful
collaboration between low- and high-resource countries
(p 2338-2346)
Helge Stalsberg, Baffour Awuah, Julio A. Ibarra, Anthony
Nsiah-Asare. 9 pages (pdf 110K). To download the pdf please
click here.
Revision surgery for breast
cancer : Single-institution experience (p 2347-2352)
Mangesh A. Thorat, Ashvin Rangole, Mandar S. Nadkarni,
Vani Parmar, Rajendra A. Badwe
6 pages (pdf 100K). To download the pdf please
click here.
Effective but cost-prohibitive
drugs in breast cancer treatment : A clinician's perspective
(p 2353-2358)
Jose Bines, Alexandru Eniu. 6 pages (pdf 124K). To download
the pdf please
click here.
Breast cancer in Latin America:
Results of the Latin American and Caribbean Society
of Medical Oncology/Breast Cancer Research Foundation
expert survey (p 2359-2365)
Eduardo Cazap, Antonio Carlos Buzaid, Carlos Garbino,
et al. 7 pages (pdf 120K). To download the pdf please
click here.
Guidelines
for International Breast Health and Cancer Control
Published as: 2005 Guidelines for International Breast
Health and Cancer Control, The Breast Journal, Jan/Feb.
2006 Supplement. Please clcik on the title to download
the pdf.
These guidelines were by the end
of 2008, please make sure you visit the BHGI
website for updates
European Society for Medical
Oncology (ESMO) Minimum Clinical Recommendations for
diagnosis, adjuvant treatment and follow-up of primary
breast cancer
B. C. Pestalozzi, E. Luporsi-Gely, L. M. Jost, and J.
Bergh, 2005, Annals of Oncology. 16 pages i7-i9 (pdf
48K). To download the pdf please
click here
Review: Second consensus
on medical treatment of metastaticbreast
cancer
Annals of Oncology 18: 215-225, 2007, S.
Beslija, J. Bonneterre, H. Burstein, V. Cocquyt, et al.
11 pages (pdf 116K). Please
click here
Clinical Practice Guidelines
for the Management of Early Breast Cancer - Second
Edition
The National Health and Medical Research Council (NHMRC),
Australia, 2001, 210 pages (pdf 719kb)
Clinical practice guidelines for
the management of early breast cancer aims to be a document
useful for both health professionals and consumers. It
is designed to:
* Assist in decision-making
by women and their doctors;
* Educate all involved in the care of women with breast
cancer;
* Assess and assure the quality of care;
* Reduce the risk of legal liability by improving care;
and
* Bring the issue of cost-effectiveness into the public
arena.
This book presents guidelines, and
does not pretend to be a textbook. Clinicians looking
for further information on the biology and natural history
of breast cancer should consult the relevant texts.
The guidelines are not rigid procedural
paths, nor are they prescriptive. They aim to provide
information on which decisions can be made, rather than
dictate what the decisions should be.
The guidelines are designed to provide
information to assist decision making and are based on
the best evidence available at time of publication. They
are a guide to appropriate practice, to be followed subject
to the clinician's judgment and the woman's preference
in each individual case.
This is the second edition of the
Clinical practice guidelines for the management of early
breast cancer and replaces the first edition released
in 1995. To download the pdf please
click here
American Cancer Society Guidelines
for Breast Cancer Screening: Update 2003
Robert A. Smith, Debbie Saslow, Kimberly Andrews Sawyer,
et al. CA Cancer J Clin 2003 53: 141-169. 30 pages (pdf
141). To download the pdf please
click here
Editorial: Breast Cancer
in Developing Countries: Challenges for Multidisciplinary
Care Breast Care 2008;3:4-5, Raimund Jakesz. 2 pages
(pdf 32K). To download the pdf please
click here
American Cancer Society Guidelines
for Breast Screening with MRI as an Adjunct to Mammography
Debbie Saslow, Carla Boetes, Wylie Burke, et al. for
the American Cancer Society Breast Cancer Advisory Group.
CA Cancer J Clin 2007 57: 75-89. 18 pages (pdf 336K).
To download the pdf please
click here
NCCN Treatment Guidelines
for Patients: Breast Cancer
ACS and National Comprehensive Cancer network (NCCN)
2007, 96 pages (pdf 788K) to download the pdf please
click here
NCCN Clinical Practice Guidelines:
Breast Cancer Risk Reduction
National Comprehensive Cancer Network (NCCN) 2008, 39
pages (pdf 428K) to download the pdf please
click here
NCCN Clinical Practice Guidelines:
Breast Cancer Screening and Diagnosis Guidelines
National Comprehensive Cancer Network (NCCN) 2008, 38
pages (pdf 226K) to download the pdf please
click here
The National Comprehensive
Cancer Network’s NCCN Clinical Practice Guidelines
in Oncology™ are one of the most comprehensive and
most frequently updated clinical practice guidelines
available in any area of Medicine. Covering 97 percent
of all patients with cancer and updated on a continual
basis, the NCCN Guidelines are developed through an
explicit review of the evidence integrated with expert
medical judgment by multidisciplinary panels from NCCN
Member Institutions. Treatment recommendations are
specific and are implemented through performance measurement.
NCCN Guidelines Panels address cancer detection, prevention
and risk reduction, workup and diagnosis, treatment
and supportive care. Please visit the NCCN website
to ensure you have the latest treatment guidelines
available, since they are updated almost every year:
(free log in required to get to the guidelines) click
here
Clinical practice guidelines
for the management and support of younger women with
breast cancer
The National Health and Medical Research Council (NHMRC),
Australia, 2003, 114 pages (PDF, 417kb). This externally
developed document provides information assisting younger
women and their doctors in making decisions about all
aspects of breast cancer care. To download the pdf please
click here
ESMO Minimum Clinical Recommendations
The European Society for Medical Oncology (ESMO) is continuing
to expand and update its internationally respected
collection of Minimum Clinical Recommendations for
the treatment of cancer ― a set of documents that provide
up-to-date information free of charge for oncologists
around the world.
A new issue of ESMO's scientific journal, Annals of Oncology,
is now available. This informative, new supplement contains
35 of the most up-to-date Minimum Clinical Recommendations
and is an excellent source of useful information.
ESMO Minimum Clinical Recommendations:
May 2005; Vol. 16, Supplement No. 1 can be pre-viewed
on-line only. Please
click here
Each of the recommendations provides
vital, evidence-based information for physicians, including
the incidence of the malignancy, diagnostic criteria,
staging of disease and risk assessment, treatment plans
and follow-up. The recommendations are intended to provide
the user with a set of requirements for a basic standard
of care that ESMO would consider necessary in all countries
of Europe. They are not designed to replace extensive
clinical practice guidelines or review articles, but
to describe minimum common standards. Considering the
rapid changes in the field of medical oncology, each
guideline undergoes a yearly update.
Cancer Screening in the United
States, 2008: A Review of Current American Cancer Society
Guidelines and Cancer Screening Issues
Robert A. Smith, Vilma Cokkinides, and Otis Webb Brawley.
CA Cancer J Clin 2008 58: 161-179. 20 pages (pdf 161K),
To download the pdf please
click here
ADDitional RESOURCES (practitioners)
The
resources listed here are organized by relevance. They
are published by well-known organizations working on
breast cancer. All PDF files listed can be downloaded
from the pacificcancer.org website, without having
to visit any other site.
