title: Supportive care during treatment for breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement.
abstract: Breast cancer patients may have unmet supportive care needs during treatment, including symptom management of treatment-related toxicities, and educational, psychosocial, and spiritual needs. Delivery of supportive care is often a low priority in low- and middle-income settings, and is also dependent on resources available. This consensus statement describes twelve key recommendations for supportive care during treatment in low- and middle-income countries, identified by an expert international panel as part of the 5th Breast Health Global Initiative (BHGI) Global Summit for Supportive Care, which was held in October 2012, in Vienna, Austria. Panel recommendations are presented in a 4-tier resource-stratified table to illustrate how health systems can provide supportive care services during treatment to breast cancer patients, starting at a basic level of resource allocation and incrementally adding program resources as they become available. These recommendations include: health professional and patient and family education; management of treatment related toxicities, management of treatment-related symptoms of fatigue, insomnia and non-specific pain, and management of psychosocial and spiritual issues related to breast cancer treatment. Establishing supportive care during breast cancer treatment will help ensure that breast cancer patients receive comprehensive care that can help 1) improve adherence to treatment recommendations, 2) manage treatment-related toxicities and other treatment related symptoms, and 3) address the psychosocial and spiritual aspects of breast cancer and breast cancer treatments.
authors.affiliation: Champalimaud Cancer Center, Lisbon, Portugal.
authors.forename: Fatima
authors.initials: F
authors.lastname: Cardoso
authors.forename: Nuran
authors.initials: N
authors.lastname: Bese
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Distelhorst
authors.forename: Jose Luiz B
authors.initials: JL
authors.lastname: Bevilacqua
authors.forename: Ophira
authors.initials: O
authors.lastname: Ginsburg
authors.forename: Steven M
authors.initials: SM
authors.lastname: Grunberg
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gralla
authors.forename: Ann
authors.initials: A
authors.lastname: Steyn
authors.forename: Olivia
authors.initials: O
authors.lastname: Pagani
authors.forename: Ann H
authors.initials: AH
authors.lastname: Partridge
authors.forename: Felicia Marie
authors.initials: FM
authors.lastname: Knaul
authors.forename: Matti S
authors.initials: MS
authors.lastname: Aapro
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Andersen
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000150:complications / Q000191:economics / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D003906:Developing Countries; D064420:Drug-Related Side Effects and Adverse Reactions / Q000628:therapy; D005221:Fatigue / Q000628:therapy; D005260:Female; D006282:Health Personnel / Q000193:education; D006801:Humans; D059408:Pain Management; D010353:Patient Education as Topic; D011183:Postoperative Complications / Q000628:therapy; D040841:Resource Allocation
chemical_list: D000970:Antineoplastic Agents
keywords: Breast cancer; Low- and middle-income countries; Resource allocations; Supportive care; Treatment toxicities