Applicability of western guidelines in low and middle-income countries for locally advanced breast cancer: from “minimal requirements” to optimal management in 2025
Year: 2026
Type: article
Abstract: 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.
DOI: 10.5603/rpor.114286
Authors: Yazid Belkacemi, Kamel Debbi, Alphonse G. Taghian, Ahmad Hussein Awada, Marie-Pierre Chauvet, Fatima Zahra Bellefkih, Fady Geara, Hassan Errihani, Meteb Al-Foheidi, Narjiss Berrada, Mohammed Oukkal, Lala Kawtar El-Hassani, Pelegia P. Tsoutsou, Zakia Benlahrech, Mohamed Adnane Bahi, Hussein Adlane Dib, Esat Mahmut Ozsahin, Sidy Ka, Hamouda Boussen, Amina Gheribi, Wissal Hassani, Pelin Altinok, Irem Yüksel, Cemal Ugur Dursun, Qianqian Lei, Djaouida Hasnaoui, Taoufiq Barrou, Kahina Amichi Aberkane, Youssef Bensouda, Atagun Bolukbasi, Bushra Bushra Al-Quadi, Sedat Turkan, Julian Malicki, Banu Atalar, Redouane Samlali, Adda Bounedjar, Joseph Gligorov
Institutions: Inserm, Université Paris-Est Créteil, Assistance Publique – Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Institut Mondor de Recherche Biomédicale, Harvard University, Massachusetts General Hospital, Centre Hospitalier Interrégional Edith Cavell, Centre Oscar Lambret, University of Hassan II Casablanca, Cleveland Clinic Abu Dhabi, Mohammed V University, Institut National d'Oncologie, King Saud bin Abdulaziz University for Health Sciences, University of Geneva, Hôpital Riviera-Chablais, Cheikh Anta Diop University, Abderrahmane Mami Hospital, Centre Hospitalier Universitaire Hassan II, Ümraniye Eğitim ve Araştırma Hastanesi, Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, Chongqing University, Chongqing Cancer Hospital, Koç University, Istanbul University-Cerrahpaşa, Poznan University of Medical Sciences, Greater Poland Cancer Center, Acıbadem University, University of Boumerdes, University of Blida, Sorbonne Université
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $1,713
OpenAlex ID: W7204466657