Breast Cancer
Our programme improving surgical capacity for women with breast cancer.
The Breast Cancer Programme within Women’s Health at the GSF aims to improve patient outcomes through improved access to safe, timely, and respectful breast cancer surgical care.
Access to surgical care is critical along the breast cancer patient pathway, from diagnosis to treatment to palliative care and reconstruction. Surgical intervention is required in over 80% of breast cancer cases, yet only 25% of the world has access to the necessary surgical care.
In fact, only an estimated 8% of the population in low- and lower-middle income countries have access to surgery, and as low as 2% in some low-income countries.
Our mission
Our mission is to improve the health of women, families, and communities in low- and middle-income countries by accelerating access to safe surgical care through locally-led, innovative, evidence-based, and sustainable programmes.
Our work is aligned with the World Health Organisation Global Breast Cancer Initiative (WHO GBCI), which aims to reduce breast cancer mortality by 2.5% per year.
Over 20 years, this could save 2.5 million lives.
In 2022, breast cancer caused 666,103 deaths and was the second most common cancer worldwide.
1 in 12 women will be diagnosed with breast cancer in their lifetime
In some low-income countries, the surgical workforce will have to increase by 4x to fulfill the demand for cancer surgeries.
44
Health centres engaged in Rwanda and Türkiye
Our reach
1,733
Breast cancer patients and women reached
197
Healthcare workers engaged
Strengthening surgical capacity along the continuum of care
The projects are locally led. We work alongside local stakeholders to co-design programmes that are context appropriate and sustainable.
The GSF Women’s Health Programme brings together and coordinates partners along the continuum of care for breast cancer patients, to support access to surgical care from a multidisciplinary perspective.
The continuum of breast cancer care
Our approach
We use a five-pillared approach for system-level, sustainable change to improve outcomes for patients.
Based on the WHO GBCI pillars, our interventions aim to build capacity for increased access with and by local communities, combining facility assessment, workforce training, patient navigation, and community engagement at the decentralised level.
Our work includes activities such as:
Training of surgical teams using a hub-and-spoke model to strengthen capacity to manage breast cancer cases
Patient navigation programmes to support referral systems and consolidate care along the continuum for patients, and reduce delay between diagnosis and treatment
Patient support initiatives, such as peer-to-peer or community support to address stigma
Data collection around post-operative outcomes and experience of care to inform policy changes
Value-based healthcare in practice
We carefully build local capacity and leadership in our target countries.
1. Country-preparedness
We engaged stakeholders to understand and align priorities and raised awareness on VBHC more broadly. We developed partnerships through roundtable discussions and established technical expert working groups in country, to co-create and design contextualised programming with local ownership.
2. Needs assessment
In the current phase, we’ve launched needs assessments in Rwanda and Türkiye to better understand patient and provider perspectives and identify gaps and barriers for accessing surgical care for breast cancer.
3. Pilot
Building upon the findings of the needs assessments, the project team will support the development of contextualised quality improvement interventions to address gaps and barriers identified, integrating VBHC principles.
4. Policy and scale up
Following the pilot, insights gained, and lessons learned will be compiled for dissemination, and the technical expert working groups will develop policy recommendations for adaptation and scale up.
Projects
We are building our diverse portfolio of breast cancer projects.
In collaboration with the United Nations Institute for Training and Research (UNITAR) and Takeda, we recently completed two comprehensive needs assessments in Türkiye and Rwanda to identify the key gaps in access to safe and quality surgical care for breast cancer patients.
In-country needs assessments
The needs assessments focused on both patient and provider perspectives. In Türkiye, we worked with Marmara University and Zonguldak Bulent Ecevit University to implement a qualitative study on delays in screening and a quantitative study of breast cancer patients on delays in diagnosis and treatment, respectively. In Rwanda, the University of Global Health Equity led a comprehensive three-part study of the state of breast cancer care at Butaro Cancer Centre of Excellence.
Rwanda
Clinical and surgical breast cancer outcomes at Butaro District Hospital
This project created a baseline of clinical and surgical outcomes for breast cancer patients treated at Butaro District Hospital via a retrospective chart review.
Gaps in general surgeon training, knowledge, and management of breast cancer in Rwanda
This project evaluated the overall knowledge base of general surgeons in Rwanda, and identify gaps in training, knowledge, and management of breast cancer in Rwanda via a targeted cross-sectional survey of general surgeons across the country.
Qualitative assessment of breast cancer diagnosis and treatment stigma
This project identified stigma related to breast cancer diagnosis and surgical management of patients at Butaro Cancer Centre of Excellence through qualitative interviews of patients.
Türkiye
Perception, beliefs, and behaviours affecting early diagnosis of breast cancer in Türkiye
This project identified key barriers associated with delays in early screening and detection of breast cancer through interviews with women, healthcare workers, and KETEM facility workers.
The etiological causes of diagnostic and treatment delays in locally advanced breast cancer – a nationwide survey trial
This project determined key factors associated with delayed diagnosis and treatment, and the effects of such delays on patient-reported outcomes through a hospital-based survey of breast cancer patients.
Project partners
We work with our local and international partners to deliver this locally led, locally driven project.
The data acquired from this project, that is created with the collaboration of Zonguldak Bulent Ecevit University School of Medicine and the GSF-UNITAR team, has the potential to enhance the quality of breast cancer care in Türkiye.
Prof. Dr. Güldeniz Karadeniz Çakmak
Zonguldak Bulent Ecevit University School of Medicine
Project Lead
More of our work
Other projects led by our partners and supported by the GSF.
KENYA
Nakuru County
Safe, timely and respectful caesarean care for over 25,000 women giving birth each year across five facilities in Nakuru County.
GLOBAL · ONLINE LEARNING
SURGhub
The UN Global Surgery Learning Hub: free online courses for surgical, obstetric and anaesthesia teams, with more than 110,000 course enrolments.
NIGERIA
Kano State
Safe, timely and respectful caesarean care for over 27,000 women giving birth each year in Kano State.
NEPAL
Koshi Province
Reducing deaths and complications linked to caesarean section for mothers and newborns in Koshi Province.
TANZANIA
Building Bridges for Broken Bones
Better fracture care in rural Tanzania through training and collaboration between traditional bonesetters and surgeons.
RWANDA
Breast cancer surgery
Improving outcomes for women with breast cancer in Rwanda through better training, patient navigation and data systems.
PAKISTAN · NEPAL
National surgical planning
Helping ministries of health plan how to expand access to safe surgical care, with the NSOAP Manual and country support.
PREVIOUS PROJECT
C-Safe
Developing, implementing and evaluating a strategy to reduce maternal and newborn deaths and complications following caesarean section in low- and middle-income countries.