title: Breast Cancer in Africa: Limitations and Opportunities for Application of Genomic Medicine.
abstract: As genomic medicine gains clinical applicability across a spectrum of diseases, insufficient application in low-income settings stands to increase health disparity. Breast cancer screening, diagnosis, and treatment have benefited greatly from genomic medicine in high-income settings. As breast cancer is a leading cause of both cancer incidence and mortality in Africa, attention and resources must be applied to research and clinical initiatives to integrate genomic medicine into breast cancer care. In terms of research, there is a paucity of investigations into genetic determinants of breast cancer specific to African populations, despite consensus in the literature that predisposition and susceptibility genes vary between populations. Therefore, we need targeted strengthening of existing research efforts and support of new initiatives. Results will improve clinical care through screening and diagnosis with genetic testing specific to breast cancer in African populations. Clinically, genomic medicine can provide information capable of improving resource allocation to the population which most stands to benefit from increased screening or tailored treatment modalities. In situations where mammography or chemotherapy options are limited, this information will allow for the greatest impact. Implementation of genomic medicine will face numerous systemic barriers but is essential to improve breast cancer outcomes and survival.
authors.affiliation: Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA 02115, USA; University of Miami Miller School of Medicine, Miami, FL 33136, USA; Rwanda Military Hospital, Kigali, Rwanda.
authors.forename: Allison
authors.identifier: 0000-0003-4188-8424
authors.initials: A
authors.lastname: Silverstein
authors.affiliation: Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA 02115, USA; University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Rachita
authors.initials: R
authors.lastname: Sood
authors.affiliation: Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA 02115, USA; Rwanda Military Hospital, Kigali, Rwanda.
authors.forename: Ainhoa
authors.identifier: 0000-0002-0943-2892
authors.initials: A
authors.lastname: Costas-Chavarri