Breast cancer is the leading cause of death among women worldwide, yet, 75% of global deaths attributed to breast cancer occur in the developing world. Women in low and middle income countries are unduly undereducated, underserved and underinsured as well. These women suffer from the limited resources, inadequate health education and above all, they do not have an organized access to preventive and diagnostic procedures.
The importance of early diagnosis of breast cancer in reducing mortality has been demonstrated in many long-term studies of organized breast screening programs. Because approximately 1 in 10 women with a breast mass or abnormal mammography result will have breast cancer, a sequence of decisions must be taken to exclude or establish a diagnosis of breast cancer among these women. To establish a definite diagnosis, it is essential to refer patients for additional diagnostic services, including diagnostic mammography, ultrasonography, ultrasonography-guided biopsy, stereotactic biopsy and breast magnetic resonance imaging.
According to the global initiative awareness in Egypt, community profile findings in Alexandria, 2010, treatment expenses were not the sole barriers against Egyptian women in joining early detection programs. Misbelieves that treatment will work constituted 60.9% of restrictive barriers while 51.4% of women had ignorance of service location which means they do not know where or whom to go to if they discover symptoms of breast cancer.
Thus, it is quite obvious that the problem of breast cancer in developing countries is not only confined to the diverse barriers for participation in screening programs but is overwhelmed with the delay in the treatment of women with mammography signs suggestive of breast cancer. Delay in the treatment of breast cancer results in a considerable increase in the breast carcinoma death rate. Furthermore, it has long been apparent from many studies that such delay, and its lethal consequence, is also one of the most expensive malpractice category
In spite of the fact that the Egyptian National Screening Program, "The Women health Outreach program (WHOP)" offers completely free of charge post mammography diagnostic services for all Egyptian women joining the program, 65.6% of the ladies with suspicious mammography findings refused to join these services. On recall, they declared variable misconceptions and they had various adaptive and accessibility problems.
Thus, it has become essential to design special programs for underserved and under insured Egyptian women to eliminate delays in diagnostic resolution of abnormal screening mammograms, provide services for abnormalities noted during breast cancer screening, and to describe and assess post screening follow-up care.