Epidemiology, screening and diagnosis of breast cancer in the Asia-Pacific region: Current perspectives and important considerations

Because the Asia-Pacific region contains approximately 25% of the world's population, the rapidly rising incidence of breast cancer in this area represents a serious global health problem. Epidemiologic and biologic profiles of breast cancer in the Asia-Pacific region differ from those in Western countries. Compared with the West, breast cancer occurs more frequently among young premenopausal women and women in urban areas. Breast cancer is also more frequently diagnosed in advanced stages than in Western countries, and tumors are more likely to be estrogen receptor- and progesterone receptor-negative. These differences can impact treatment selection, response to treatment, and outcomes, including morbidity and mortality. Breast cancer mortality in some countries of the Asia-Pacific region is two-fold higher than in Western countries. The screening, diagnosis, and management of patients with breast cancer in the Asia-Pacific region are associated with a number of unique challenges. These include patient misperceptions about the disease and its treatment, a lack of access to imaging equipment and diagnostic testing, inconsistencies in the implementation of breast cancer screening programs and limited access to expensive treatments. Whereas some of the more Westernized countries within this region have established screening programs, many areas are still lacking in adequate breast cancer screening facilities. Various cultural and economic barriers must be addressed to improve treatment and outcomes for Asian-Pacific patients with breast cancer.