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The Role of Guidelines in Breast Cancer Management in Different Resource Settings

Abstract: Clinical Practice Guidelines (CPGs) translate evidence-based research into methodological standards. A variety of CPGs have been developed to guide management of breast cancer to optimize patient care. Adherence to existing guidelines in high-income countries (HICs) is associated with improved patient outcomes. However, these guidelines were developed for use in high-resource settings and assume high rates of healthcare spending and timely access to effective diagnostic and treatment modalities. There exist significant barriers to their implementation in low- and middle-income countries (LMICs). The Breast Health Global Initiative (BHGI), via a series of collaborative Global Summits from 2002 to 2013, developed a resource-stratified framework to guide all aspects of breast cancer control across all resource settings. The chapter describes CPG development, their impact on patient outcomes, and barriers to their uptake both in HICs and LMICs. It also describes BHGI resource-stratified guidelines and future directions to develop and assess implementation of these guidelines in resource-constrained settings.