title: Taking on breast cancer in East Africa: global challenges in breast cancer.
abstract: OBJECTIVE
  To provide an update on breast cancer epidemiology, early detection, and therapy in Africa.
  
  
  RESULTS
  Breast cancer has been a long neglected topic in Africa. Due to increased activities of population-based cancer registries, cancer incidence rates become available. Data from 26 African countries for 2012 suggest that in the majority of countries, breast cancer has turned into the leading cancer among the female population. Yet data from hospital-based registries show that patients often present late. Efforts are being made to implement early detection programs; however, there are open questions how best to organize screening activities, referral and how to assure pathology service. Adjuvant treatment is still limited to a small number of centers; neoadjuvant treatment is underutilized. New data have become available from different countries reporting high proportions of estrogen receptor-positive tumors, which would possibly justify the administration of tamoxifen in unknown receptor status.
  
  
  CONCLUSIONS
  Breast cancer is an increasing health problem in low-resource countries. More information on incidence, clinical presentation, outcome, and tumor biology in Africa has become available. Further evidence is needed on strategies to improve awareness, appropriate treatment options, and implementation of palliative care.
  http://links.lww.com/COOG/A17
authors.affiliation: aDepartment of Gynecology, Martin-Luther-Universität Halle an der Saale, Halle an der Saale, Germany bChris Hani Baragwanath Academic Hospital, Soweto cUniversity of the Witwatersrand, Braamfontein, Johannesburg, South Africa dDepartment of Public Health Science, Karolinska Institute, Stockholm, Sweden eIfakara Health Institute, Dar Es Salaam, Tanzania.
authors.forename: Eva Johanna
authors.initials: EJ
authors.lastname: Kantelhardt
authors.forename: Herbert
authors.initials: H
authors.lastname: Cubasch
authors.forename: Claudia
authors.initials: C
authors.lastname: Hanson
mesh_terms: D000351:Africa, Eastern / Q000453:epidemiology; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control; D003131:Combined Modality Therapy; D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D055088:Early Detection of Cancer; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000706:statistics & numerical data; D008408:Mastectomy / Q000706:statistics & numerical data; D011159:Population Surveillance; D012017:Referral and Consultation; D012042:Registries
chemical_list: D018931:Antineoplastic Agents, Hormonal