The first BGICC consensus and recommendations for breast cancer awareness, early detection and risk reduction in low- and middle-income countries and the MENA Region.

In Low-middle income countries (LMICs) and the Middle East and North Africa (MENA) region, there is an unmet need to establish and improve breast cancer (BC) awareness, early diagnosis and risk reduction programs. During the 12th BGICC - Egypt 2020, 26 experts from 7 countries worldwide voted to establish the first consensus for BC awareness, early detection and risk reduction in LMICs/MENA region. The panel advised that there is an extreme necessity for a well-developed BC data registries and prospective clinical studies that address alternative modalities/ modified BC screening programs in areas of limited resources. The most important recommendations of the panel were: 1-BC awareness campaigns should be promoted to public and all adult age groups; 2-early detection programs should combine geographically distributed mammographic facilities with clinical breast examination (CBE); 3- breast awareness should be encouraged; and 4- intensive surveillance and chemoprevention strategies should be fostered for high risk women. The panel defined some areas for future clinical research, which included the role of CBE and breast self-examination as an alternative to radiological screening in areas of limited resources, the interval and methodology of BC surveillance in women with increased risk of BC and the use of low dose tamoxifen in BC risk reduction. In LMICs/MENA region, BC awareness and early detection campaigns should take into consideration the specific disease criteria and the socio-economic status of the target population. The statements with no consensus reached, should serve as potential catalyst for future clinical research.