Breast cancer from a public health perspective.
By 2010, the majority of approximately 1.5 million annual new cases of breast cancer will be diagnosed in women in countries with limited resources. Public health approaches to medical problems emphasize the importance of practical, limited toxicity and very inexpensive interventions. While clinical trials in Western countries are testing the concept of breast cancer prevention, they are not defining useful public health approaches. Early detection of breast cancer using mammography, while effective, is a high-technology, expensive approach. Adjuvant systemic and radiation therapies are increasingly expensive; careful consideration of efficacy and cost-efficacy data appear warranted. Public health perspectives thus suggest that many current "standard" approaches to breast cancer in Western countries cannot help the majority of women in the world.
Department of Medicine, University of Wisconsin, and University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin, USA. rrlove@facstaff.wisc.edu
Richard R
RR
Love
Susan M
SM
Love
Adriano V
AV
Laudico
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000191:economics / Q000706:statistics & numerical data; D003906:Developing Countries; D005260:Female; D014943:Global Health; D006801:Humans; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D011634:Public Health; D016387:Women's Health