Breast cancer constitutes about one fourth of the registered cancer cases among the Iraqi population (1)
and it is the leading cause of death among Iraqi women (2)
. Each year more women are exposed to the vicious
ramifications of this disease which include death if left unmanaged or the negative sequels that they would
experience, cosmetically and psychologically, after exposure to radical mastectomy.
The World Health Organization (WHO) documented that early detection and screening, when coped
with adequate therapy, could offer a reduction in breast cancer mortality; displaying that the low survival rates
in less developed countries, including Iraq, is mainly attributed to the lack of early detection programs coupled
with inadequate diagnostic and treatment facilities (3)
. Although mammography machines, as main screening
tools for breast cancer, are available in the major hospitals in each province in Iraq, yet those are mainly used
for diagnostic purposes in patients who present with palpable breast lumps. Obviously, due to cost effective
measures, lack of resources and the economical challenges that Iraq is facing, it is not expected that the
authorities could provide mammography devices across every health care centre in the country to be used for
screening of all Iraqi women.
Accordingly, promoting other feasible tools could support in solving that dilemma. Clinical Breast
Examination (CBE) for women, by highly trained health care providers in Primary Health Care Centers, along
with diagnostic mammography in the major hospitals for referred cases, could offer cost effective approaches
for early detection of breast cancer in Iraq. The resources required to provide these services are within the
reach of all countries with limited resources
(4)
.
The issue of raising awareness on breast cancer and its early detection measures needs to be addressed.
Observations reported in Iraqi studies obviously reflect the the limited knowledge of the general population
about the disease, its preventive measures and their ignorance regarding the significance of CBE and early
medical consultation (5, 6)
. Public health awareness campaigns should be endorsed by policy makers to encourage every Iraqi women to look for abnormal signs and symptoms in their breasts and to seek medical
advice promptly.
The Environmental Management System (EMS) is an important foundation for effective control of the organization's outstanding environmental performance. It applies standards for substantive review and provides a structure and a way to apply it in all aspects of th