Manzano A, Hofmarcher T

Improving outcomes for women with triple-negative breast cancer in Asia-Pacific

Breast cancer is a major and growing public health concern in the Asia-Pacific region. One of the most aggressive and challenging subtypes of breast cancer is triple-negative breast cancer (TNBC), accounting for 9–13% of all breast cancer cases. This report takes a closer look at challenges and opportunities to improve the care of TNBC in Asia-Pacific, with a focus on Australia, Hong Kong, South Korea, Taiwan, and Thailand.

TNBC is often diagnosed at a late stage when the tumor has already started to spread and when survival chances are low. Early detection – through self-detection and screening – is therefore imperative. Current challenges for early detection of TNBC in Asia-Pacific include:
• Unawareness of early signs of breast cancer and cultural beliefs about cancer resulting in a reluctance to consult health care services upon noticing symptoms
• Absence of organized population-based screening programs
• Non-participation in screening programs due to various misconceptions

TNBC is the most difficult-to-treat subtype of breast cancer irrespective of stage at diagnosis. Alongside surgery and radiation therapy, chemotherapy used to be the only treatment option in TNBC. The recent introduction of immunotherapy and targeted therapy (for patients with BRCA mutations) is currently changing the treatment landscape. Timely breast diagnostics and appropriate treatment are vital to enhance the survival prospects of patients. Current challenges in the areas of diagnostics and treatment of TNBC in Asia-Pacific include:
• Geographical barriers to access diagnostic imaging services
• Uncoordinated organization of diagnostic testing
• High patient copayments for cancer care services
• Slow adoption of new treatment approaches in clinical practice

Broad recommendations to improve the care of TNBC patients in the Asia-Pacific region include efforts to raise health literacy to facilitate early detection, ensure optimal care delivery along the entire patient pathway, and adoption of innovation in clinical practice. Improving the quality of care – from early detection to diagnostics and treatment – has wider positive implications for society, including effects on health systems, work life, family life, the need for informal care, and the economy.

IHE Report 2023:3, IHE: Lund, Sweden