High-value breast cancer care within resource limitations

Area of Science:

• Oncology
• Global Health
• Health Economics

Background:

• Breast cancer care presents a significant global health cost, with diagnosis often leading to financial hardship, particularly in low- and middle-income countries (LMIC).
• Substantial inequities exist in breast cancer care, posing challenges for both patients and healthcare providers worldwide.
• Early detection strategies vary, including awareness and clinical breast examination in LMIC, and screening in high-income countries (HIC).

Purpose of the Study:

• To highlight the need for effective, equitable, and value-based breast cancer management strategies globally.
• To emphasize the importance of adapting clinical guidelines and implementing integrated practice units for personalized care.
• To advocate for the inclusion of quality of life and financial cost evaluations in assessing breast cancer outcomes.

Main Methods:

• Review of current breast cancer care disparities and management strategies in high-income countries (HIC) and low- and middle-income countries (LMIC).
• Proposal for integrated practice units (IPU) featuring multidisciplinary care conferences and patient navigators.
• Emphasis on incorporating patient-reported outcomes (PROM) and patient experience measurements (PREM) alongside financial cost analysis.

Main Results:

• Integrated practice units and patient navigators are crucial for high-value, personalized breast cancer management in both HIC and LMIC.
• Evaluating care quality must include patient-reported outcomes, experience measurements, and the financial cost of treatment.
• Addressing systemic inequities and translating research findings into practice are essential for improving care value.

Conclusions:

• Implementing integrated practice units and patient navigators can enhance breast cancer care delivery and outcomes globally.
• A value-based approach, incorporating quality of life and cost-effectiveness, should guide resource allocation and research priorities.
• Further attention is needed for metastatic breast cancer treatment, particularly in LMIC, alongside robust cancer survivorship programs.