Applicability of western guidelines in low and middle-income countries for locally advanced breast cancer: from “minimal requirements” to optimal management in 2025

Résumé fourni par la source

Locally advanced breast cancer (LABC) is still a concern in low- and middle-income countries (LMICs) where the limited availability of human resources and means do not allow implementation of the guidelines that are elaborated in high-income countries (HICs). Thus, guidelines for BC care must take into account the differences in regional development, the availability of diagnostic tools, the cost-effectiveness of the treatment methods, and the socio-cultural context for BC management. In this report, we aimed to focus on the applicability of the Western guidelines in LMICs for LABC, including the identification of “minimal requirements” that should be offered to patients in the context of lack of means and the “optimal care” which should be the realistic goal to reach according to human resources and means availability. The conclusions regarding locoregional and systemic treatments for the different LABC molecular subtypes have been validated by all experts for all adjuvant and neoadjuvant settings. “Minimal requirements and optimal care” will be discussed for axillary management in the sentinel node biopsy era, for regional nodal irradiation after primary systemic therapy according to the response, and for neoadjuvant systemic therapies according to the BC subtypes.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.