Pathology And Breast Cancer At A Global Level
The discussion will now focus on pathology and breast cancer at a global level and the challenges that come along with access to breast pathology. Moreover, we should discuss more to overcome the challenges to address this problem.
Breast Cancer is A Major Public Health Concern to Date:
It is the most commonly found cancer among women around the world and accounts for 22% of the 4.7 million cancers reported each year. It is also the 2nd leading cause of death due to cancer in women. Women who die because of breast cancer lose around twenty years of their life, and the majority of deaths due to breast cancer occur in developing countries.
Undoubtedly, breast cancer is a major global issue because of the morbidity and the psycho-social and sexual disturbances that patients experience along with this life-threatening disease.
The importance of the disease has resulted in much new advancement in past years. The most notable of such advancements are enhanced breast imaging and mammography screening. Other major advancements include molecular targeted therapy that offers personalized breast care focusing on each breast cancer patient.
Mortality Rates Due To Breast Cancer
This kind of progress has reduced mortality rates due to breast cancer. Since 1990, a 1 to 2% reduction in mortality from breast cancer has been seen in developed countries like Canada, USA, and Europe. But the mortality rate continues to increase in developing countries and populations where people are medically underserved.
The underserved population is one where breast cancer cases are neglected. All medically underserved patients are observed at the University of Florida in Jacksonville, USA. These are people who come in for emergencies and whose biopsies and diagnoses are made. Then they are sent to palliative care therapy centers. These are examples commonly seen in developing countries, and every time this kind of situation occurs, it questions the healthcare facilities of their standards and services being offered. Some lesions cannot be characterized as lesions and can never threaten human life. Many resources are spent on such cases, and more threatening issues are ignored.
In short, progress in breast cancer survival can be made if resources are invested wisely. With this, the mortality rate can be reduced by applying appropriate changes in the breast cancer care field.
What are Obstacles? Why the Goal Cannot Be Achieved?
The diverse patient population with different social and genetic backgrounds, religions, beliefs, lifestyles, rituals, cultures, and economic differences are the major hurdles to the achievement of goals set for improvements in breast cancer treatment and management.
Discussing breast pathology and breast cancer without considering the barriers and their inter-relationships is impossible.
When global health, the social and economic factors of the health disparities include social status, gender, prestige, traditions, culture, power, income, family, community thoughts, social support, education, and access to health care services.
When these challenges are viewed closely, they are said to be involved in infectious disease, cancer, maternal death, fetal death, chronic diseases, environmental hazards, health system shortfalls, and poor health. Countries’ priorities to deal with such factors define their sincerity and commitment to fight against breast cancer and breast pathology.
Now the discussion will turn to the significant healthcare problems across the globe. When countries confront HIV or AIDS, tuberculosis, and malaria, many lives are lost. Then it is pretty challenging to ask government officials and healthcare administrators to focus on breast cancer.
The diseases mentioned above are the primary healthcare priorities of most developing countries. Non-communicable diseases and chronic diseases like strokes, heart disease, respiratory disease, diabetes, and other such diseases participate in the increased mortality rate due to chronic illness. That is why most resources are invested in treating and managing such conditions, and cancer gets neglected.
By The Year 2030
Considering cancer, where do we stand at the global level? In the year 2008, 56% of new cancers were found in developing countries. By the year 2030, this proportion will be increased by seventy percent, so it can be said that cancer is rising in the medically underserved population more than in any other nation. Cancers common across the globe are related to the lungs, breast, colon, prostate, and stomach, and global cancer must be a top priority in the global health agenda. Less than five percent of the global resources are allocated for cancer in low and average-income nations. So health care porosity and financial resources play a major role in cancer management and treatment goals.
Global health determines how a patient would be treated and how the follow-up would be made in various countries. This is a fact that is usually not recognized, unfortunately.
The challenge associated with making diagnoses and performing tissue sampling in developing countries includes the following:
- Scarce financial resources.
- Need for more adequately trained pathologists and technicians.
- Inadequate ancillary diagnostic tools.
- Inappropriate access to education.
Significant issues include recognizing the significance of pathology diagnosis, insufficient infrastructure for the optimal breast pathology process, and other relevant components related to a late-stage disease presentation.
A case involving advanced actinomycosis of the inner thigh in a small child is discussed. These things should not be seen anymore. These things can be detected readily and can be managed and treated.
This is a neglected leg abscess in a person of younger age. These cases are from African countries.
Then comes a neglected synovial sarcoma of a child.
These things are seen across the globe in underdeveloped African countries, Middle East countries, and Asian countries. Revolution is required to alter the quality of care given to patients at all levels. What can be done? What are the possible suggestions? Acknowledgment of the need to establish and improve global pathology practices is required. Recognizing the significance of breast pathology in clinical practice is also much needed.
Need of On-Site Optimum Pathology Diagnosis:
Funding opportunities must be explored to establish the fundamental infrastructure to provide on-site optimum pathology diagnosis. Cases cannot be collected, sent to another location or state, and waited months for the pathology diagnosis. This is what is going on now at the moment, and that is not acceptable. Resource allocation should be wise and appropriate, and philanthropy and partnership with national, international, and local communities should take place to modify the existing situation.
An initiative was started some nineteen years ago by a group of pathologists. An overseas pathologist foundation was set up, and some volunteers were brought forward; they visited various countries and attempted to view the status of pathology and observed what could be done to offer help and modify the system. This is just an example, and similar things have happened around the globe. Concepts have been introduced, local physicians have been trained, and technicians have been provided with relevant knowledge to provide a preliminary diagnosis on a few things that can be diagnosed.
Need of Pathology Services, And Telepathology
International collaboration and networking should be encouraged. Offering assistance in training, access to pathology services, and telepathology should be acknowledged and supported worldwide. Regional and local pathology laboratories should be developed to facilitate various countries so that less financial resources can be spent.
Telepathology is a significant area that allows seeing if preliminary tissue processing can be done along with a slide presentation and then sending it to a simple imaging technology center to explore individual cases locally. Sample can be received, and diagnosis can be made in cytology and histology, and real-time diagnosis can be provided for the patients. In this way, patients residing in developing countries can undergo therapy too.
The value of the needle aspiration biopsy and cytology must be promoted as it is the most affordable sampling procedure. This procedure, however, has been replaced by core needle biopsy in many countries that can afford to utilize this procedure. But fine needle aspiration offers valuable information related to the tumor origin and diagnosis, which is why it must be brought forth.
Brest Cancer and Breast Pathologist
In Africa, many advanced kinds of cancers have been reported. This is nothing new. But if preparation is done wisely, then cancers can be diagnosed appropriately. When the diagnosis is made, the tumor is easy to reach, manage, and treatment can be applied much more quickly.
The International Institute of breast pathology needs to be developed to act as a bridge for connecting to a diverse group of pathologists having similar beliefs of offering better quality breast pathology to all patients around the globe. SIS leaders and other officials are being pushed to create such an institute. This is a point from which energies and resources can be diverted to the local level, and partnerships be made with the local community to provide them with access to optimum-quality breast pathology.
This is the only way via which significant change can be achieved. It isn’t easy to accomplish, but this needs to happen. Pathologists come from centers where everything is readily available, and these pathologists do not know what it feels like to lose a breast due to fibroadenomas that cannot be diagnosed. There are patients worldwide with palpable lesions, benign lesions, papillomas, and fibroadenomas, and because of the unavailability of access to pathology, such patients have to undergo mastectomy. Mastectomy is the only option available to such patients, and this needs to be changed. So attempts should be made at local, regional, national, and international levels to create centers and institutes for providing quality breast pathology, and only this difference can be made at the global level.
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