Women living in the developing countries have a higher probability of dying from breast cancer as compared to those of the high income western world. According to the Globocan/IARC data the number of deaths as a percentage of incident cases in 2008 was 48% in the former and 24% in the latter. Exactly twofold. Available evidence on stage at diagnosis indicate that a much higher proportion of cases in the developing world are detected in late stages thus the potential of survival is poorer. Many reasons are given to explain these data: the stigma of breast cancer and the associated societal implications of its treatments (especially mastectomy) discourage women from seeking care early on; lack of knowledge about breast health; scant options for early detection due to limited access to routine care and examinations; and lack of access to mammography and to affordable, high-quality treatment options. In summary, lack of education to breast health awareness and complex cultural barriers do play a significant role in delaying breast cancer detection in developing countries. Increased awareness of breast cancer symptoms and potential of successful treatment of the tumor in early stages would be of great help to improve survival even without widespread use of mammography, advanced surgical procedures, and adjuvant therapies. In fact, if we examine the reasons for the remarkable improvements in the probability of survival for women diagnosed with breast cancer in the USA as compared to 60 years ago it is possible to realize that a significant result had been achieved also prior to the introduction of massive screening of the tumor simply by means of education to improve breast health awareness and to breast self examination. In the low-income developing world, the provision of better education is bound to provide a solid foundation for reducing stigma and fear that will make more effective the introduction of complex technologies for early diagnosis and the use of highly expensive drugs for adjuvant therapy.
