Guidelines for Breast Cancer diagnosis and care
in Bangladesh
Because of likely major differences in the biological characteristics of the tumors and patients, and cultural and health systems, clinical practice guidelines for breast cancer, developed almost exclusively based on high-income country experience, are inappropriate and likely ineffective in practice, cost-ineffective, and often harmful in the commonest circumstances of such patients and their health care providers in Bangladesh.
We introduce here guidelines for Bangladeshi patients which follow from our experience with several hundred women with breast cancer seen in the Amader Gram Breast Care Program in the last three years.
These guidelines reflect our beliefs regarding major uncertainties about the efficacy of many systemic therapy regimens, observations of major toxicities from treatment, and sensitivity to safety and the practical barriers to providing genuine outcome-improving interventions to Bangladeshi women with breast cancer.
These guidelines are presented as a starting point for broad efforts to improve approaches for women under challenging economic and health system circumstances.
