Breast cancer in Latin America: experts perceptions compared with medical care standards.
BACKGROUND
The BCRF II study presents a systematic review of the norms, recommendations and guidelines that are considered medical care standards (MCS) for breast cancer in 12 Latin American and Caribbean countries. Three key questions from the BCRF I survey data on early detection and diagnosis are presented to identify implementation practice patterns related to MCS.


METHODS
Information related to MCS was requested from governmental health authorities, cancer institutes, and national scientific and professional societies in 12 Latin American and Caribbean countries. Documents received were reviewed by breast cancer experts from each respective country. Three key survey questions from the BCRF I survey on early detection and diagnosis were reprocessed to provide information related to implementation practice of existing MCS.


RESULTS
All countries included in the BCRF II study had medical care standards (MCS) whether published by governmental authorities, national professional or scientific associations, cancer institutes, or adoption of international MCS. Experts reported different practice patterns at a Country level versus a Center level. Overall, 85% of the experts reported that less than 50% of the women with no symptoms undergo a mammography at the Country level compared to 43% at the Center level. For diagnostic suspicion of breast cancer, 80% of experts considered the diagnostic suspicion at a Country level to come from the patient compared to 50% at a Center level. About 30% of patients waited for more than 3 months for a diagnosis at the Country level compared to 7% at the Center level.


CONCLUSIONS
All the Latin America and Caribbean countries in the study reported the use of similar MCS for breast cancer care. The reported difference between care practiced at a Country level versus a Center level suggests the challenge is not in generating new MCS, but in implementing policies and control mechanisms for compliance with existing MCS, guaranteeing their applicability to all populations.
Cazap
E
E
Sociedad Latino Americana y del Caribe de Oncologia Medica, Buenos Aires, Argentina. ecazap@slacom.org
Buzaid
A
A
Garbino
C
C
de la Garza
J
J
Orlandi
F
F
Schwartsmann
G
G
Vallejos
C
C
Guercovich
A
A
Breitbart
G
G
D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D017691:Caribbean Region / Q000453:epidemiology; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration* / Q000592:standards; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000458:organization & administration* / Q000592:standards; D008495:Medical Oncology / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000458:organization & administration; D012959:Socioeconomic Factors; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration* / Q000592:standards