Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective
PURPOSEIn South Africa, breast care lacks governance and standardization, necessitating urgent improvements in patient outcomes. Quality improvement initiatives are urgently needed in low- and middle-income countries (LMICs), but requirements for breast centers in lower resource settings remain unde...
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2025-06-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-25-00168 |
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| author | Sarah Nietz Jenny Edge Ines Buccimazza Georgia Demetriou Mariza Tunmer Jacqueline Smilg Duvern Ramiah Peter Schoub Shane A. Norris Paul Ruff |
| author_facet | Sarah Nietz Jenny Edge Ines Buccimazza Georgia Demetriou Mariza Tunmer Jacqueline Smilg Duvern Ramiah Peter Schoub Shane A. Norris Paul Ruff |
| author_sort | Sarah Nietz |
| collection | DOAJ |
| description | PURPOSEIn South Africa, breast care lacks governance and standardization, necessitating urgent improvements in patient outcomes. Quality improvement initiatives are urgently needed in low- and middle-income countries (LMICs), but requirements for breast centers in lower resource settings remain undefined and must be tailored to local environments. This consensus document outlines the role and requirements of breast centers in LMICs and presents a step-by-step implementation plan.METHODSThe literature was systematically reviewed, and the primary review team tabulated international accreditation standards alongside the 2018 South African Clinical Guidelines for Breast Cancer Control and Management from the South African National Department of Health, along with proposed South African standards. The broader consensus panel consisted of 29 clinical experts and representatives from societies, advocacy, and funders.RESULTSWe categorized requirements into eight broader categories and achieved unanimous consensus on all requirement components, except for 1 abstention in the general specialist and expertise category. We were unable to reach consensus on the patient volume requirements for radiologists as well as for medical and clinical/radiation oncologists. Volume requirements for clinical and radiation oncologists were later provided by the South African Society of Clinical and Radiation Oncology (SASCRO), along with the volume requirements submitted by the participating radiologists. We also achieved unanimous consensus for the Breast Interest Group of Southern Africa (BIGOSA) to house the initial project implementation. This consensus document is endorsed by BIGOSA, SASCRO, and the Cancer Association of South Africa.CONCLUSIONWe emphasize the importance and necessity of breast centers in resource-constrained environments, outline the first set of requirements for breast centers tailored to LMICs in sub-Saharan Africa, and present a feasible and detailed plan for initial implementation. |
| format | Article |
| id | doaj-art-81e39757e802409f93686f055d7c66ac |
| institution | OA Journals |
| issn | 2687-8941 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-81e39757e802409f93686f055d7c66ac2025-08-20T02:36:00ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-06-011110.1200/GO-25-00168Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African PerspectiveSarah Nietz0Jenny Edge1Ines Buccimazza2Georgia Demetriou3Mariza Tunmer4Jacqueline Smilg5Duvern Ramiah6Peter Schoub7Shane A. Norris8Paul Ruff9Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Surgery, Nelson R Mandela School of Medicine, University of Kwa-Zulu Natal, Durban, South AfricaDivision of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDivision of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for the Exploration of the Deep Human Journey, University of Witwatersrand, Johannesburg, South AfricaDivision of Radiation Oncology, Department of Radiation Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaSAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDivision of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaPURPOSEIn South Africa, breast care lacks governance and standardization, necessitating urgent improvements in patient outcomes. Quality improvement initiatives are urgently needed in low- and middle-income countries (LMICs), but requirements for breast centers in lower resource settings remain undefined and must be tailored to local environments. This consensus document outlines the role and requirements of breast centers in LMICs and presents a step-by-step implementation plan.METHODSThe literature was systematically reviewed, and the primary review team tabulated international accreditation standards alongside the 2018 South African Clinical Guidelines for Breast Cancer Control and Management from the South African National Department of Health, along with proposed South African standards. The broader consensus panel consisted of 29 clinical experts and representatives from societies, advocacy, and funders.RESULTSWe categorized requirements into eight broader categories and achieved unanimous consensus on all requirement components, except for 1 abstention in the general specialist and expertise category. We were unable to reach consensus on the patient volume requirements for radiologists as well as for medical and clinical/radiation oncologists. Volume requirements for clinical and radiation oncologists were later provided by the South African Society of Clinical and Radiation Oncology (SASCRO), along with the volume requirements submitted by the participating radiologists. We also achieved unanimous consensus for the Breast Interest Group of Southern Africa (BIGOSA) to house the initial project implementation. This consensus document is endorsed by BIGOSA, SASCRO, and the Cancer Association of South Africa.CONCLUSIONWe emphasize the importance and necessity of breast centers in resource-constrained environments, outline the first set of requirements for breast centers tailored to LMICs in sub-Saharan Africa, and present a feasible and detailed plan for initial implementation.https://ascopubs.org/doi/10.1200/GO-25-00168 |
| spellingShingle | Sarah Nietz Jenny Edge Ines Buccimazza Georgia Demetriou Mariza Tunmer Jacqueline Smilg Duvern Ramiah Peter Schoub Shane A. Norris Paul Ruff Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective JCO Global Oncology |
| title | Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective |
| title_full | Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective |
| title_fullStr | Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective |
| title_full_unstemmed | Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective |
| title_short | Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective |
| title_sort | establishing requirements for breast centers in low and middle income countries a south african perspective |
| url | https://ascopubs.org/doi/10.1200/GO-25-00168 |
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