Guideline Implementation for Breast Healthcare in Low-income and Middle-income Countries Overview of the Breast Health Global Initiative Global Summit 2007
Guideline Implementation for Breast Healthcare in Low-income and Middle-income Countries Overview of the Breast Health Global Initiative Global Summit 2007
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DOI：
10.1002/cncr.23844
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发表时间：
2008-10-15
期刊：
影响因子：
6.2
通讯作者：
Harford, Joe
中科院分区：
文献类型：
--
作者：
Anderson, Benjamin O.;Yip, Cheng-Har;Harford, Joe
低收入和中等收入国家（LMC）的乳腺癌结局与以下程度相关：1）癌症在早期阶段被检测到，2）新检测到的癌症可以被正确诊断，3）适当选择的多模式治疗可以及时提供。乳腺健康全球倡议（BHGI）邀请国际专家审查和修订先前开发的BHGI资源分层指南表，用于早期检测，诊断，治疗和医疗保健系统。焦点小组讨论了乳腺病理学、放射治疗和局部晚期疾病管理方面的具体问题。根据指南分层中确定的优先级开发过程度量。研究小组指出，通过改变健康行为来预防癌症可能会影响LMC中的乳腺癌发病率，早期诊断乳腺癌将降低乳腺癌死亡率。促进乳房自我意识和临床乳房检查以及资源适应性乳房X线检查的方案是重要的早期检测步骤。乳房成像，最初使用超声波，在较高的资源水平上使用诊断性乳房X线摄影，改善了术前诊断评估，并允许图像引导的针取样。多模式治疗包括手术、放射和全身治疗。需要政府进行干预，以解决与费用高和难以获得有关的药物提供问题。指南传播和实施研究在改善护理方面发挥着至关重要的作用。LMC需要适应技术，特别是乳腺成像、病理学、放射治疗和全身治疗。应编制地方管理中心的教育和培训课程。在基于LMC的学习实验室中应用和研究，以帮助基于证据的BHGI指南的信息传递。Cancer 2008;113（8 suppl）：2221-43.发表于2008年41，美国癌症协会
Breast cancer outcomes in low- and middle-income countries (LMCs) correlate with the degree to which 1) cancers are detected at early stages, 2) newly detected cancers can be diagnosed correctly, and 3) appropriately selected multi-modality treatment can be provided properly in a timely fashion. The Breast Health Global Initiative (BHGI) invited international experts to review and revise previously developed BHGI resource-stratified guideline tables for early detection, diagnosis, treatment, and healthcare systems. Focus groups, addressed specific issues in breast pathology, radiation therapy, and management of locally advanced disease. Process metrics were developed based on the priorities established in the guideline stratification. The groups indicated that cancer prevention through health behavior modification could influence breast cancer incidence in LMCs, Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies. Government intervention is needed to address drug-delivery problems relating to high cost and poor access. Guideline dissemination and implementation research plays a crucial role in improving care. Adaptation of technology is needed in 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 BHGI guidelines. Cancer 2008;113(8 suppl):2221-43. Published 2008 41, the American Cancer Society