Breast Cancer Awareness Month, marked in countries across the world every October, helps to increase attention and support for the awareness, early detection and treatment as well as palliative care of this disease.
And it all starts right here with the Bali Pink Ribbon Foundation (BPR) annual charity 5km Fun Walk & Run set for Saturday Oct. 20 from 2pm to 9pm at ITDC Nusa Dua. The fund raising event supports the foundation’s breast cancer awareness education and screening work targeted to underprivileged women in Bali and surrounding islands.
Bali Pink Ribbon has, for the last 10 years, brought positive change for the women and families of Bali. Through media campaigns, organized screenings and outreach programs they have lifted the awareness of breast cancer on the island, even to Bali’s far-off rural areas.
According to the WHO breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer, approximately 15% of all cancer deaths among women.
In order to improve breast cancer outcomes and survival, early detection is critical. There are two early detection strategies for breast cancer: early diagnosis and screening. Limited resource settings with weak health systems where the majority of women are diagnosed in late stages should prioritize early diagnosis programs based on awareness of early signs and symptoms and prompt referral to diagnosis and treatment.
Early diagnosis strategies focus on providing timely access to cancer treatment by reducing barriers to care and/or improving access to effective diagnosis services. The goal is to increase the proportion of breast cancers identified at an early stage, allowing for more effective treatment to be used and reducing the risks of death from breast cancer.
Screening consists of testing women to identify cancers before any symptoms appear. Various methods have been evaluated as breast cancer screening tools, including mammography, clinical breast exam and breast self-exam.
Mammography: uses low-energy X-rays to identify abnormalities in the breast. It has been shown to reduce breast cancer mortality by approximately 20% in high-resource settings. WHO Position paper on mammography screening concluded that in well-resourced settings women aged 50-69 should undergo organized, population-based mammography screening if pre-specified conditions on program implementation are met. In limited resource settings with weak health systems, mammography is not cost-effective, and early detection should focus on reducing stage at diagnosis through improved awareness.
Clinical Breast Exam (CBE): is an examination of both breasts performed by a trained health professional. CBE seems to be a promising approach for low resource settings and could be implemented depending on the evidence from ongoing studies.
Because screening requires substantial investment and carries significant potential personal and financial costs, the decision to proceed with screening should be pursued only after (1) basic breast health services including effective diagnosis and timely treatment are available to an entire target group; (2) its effectiveness has been demonstrated in the region; and (3) resources are available to sustain the program and maintain quality.