Report on Early Breast Cancer Detection and its Alignment with Sustainable Development Goals

Case Study: Michaela Del Barrio

This report details the case of Michaela Del Barrio, whose experience with early-stage breast cancer highlights critical pathways for achieving Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. Her journey underscores the importance of proactive health management, equitable access to advanced medical services, and patient advocacy in reducing premature mortality from non-communicable diseases (Target 3.4).

Patient Engagement and Diagnostic Process: A Framework for SDG 3 and SDG 5

Risk Assessment and Patient Advocacy

The subject’s proactive engagement with the healthcare system serves as a model for promoting individual health and well-being. Key factors in the pre-diagnostic phase align with principles of gender equality (SDG 5) by empowering women to take control of their health outcomes.

• Predisposing Factor: A known family history of breast cancer placed the subject in a high-risk category.
• Patient Initiative: Despite initial advisories that dismissed her concerns due to age, the subject advocated for early screening options. This self-advocacy is crucial for overcoming systemic barriers and ensuring gender-responsive healthcare, a tenet of SDG 5.
• System Response: Referral to a specialized high-risk breast clinic provided access to quality, targeted healthcare services, fulfilling a core component of Universal Health Coverage (Target 3.8).

Advanced Screening and Diagnosis

The diagnostic process utilized advanced medical technologies, demonstrating the type of healthcare infrastructure necessary to meet global health targets. The early detection directly contributed to a more favorable prognosis, supporting SDG 3.4.

1. Initial Screening: A mammogram was conducted at age 36, earlier than standard recommendations for average-risk individuals.
2. Advanced Diagnostics: A subsequent breast MRI, made available through the high-risk assessment, identified two suspicious masses not detected by the mammogram. This highlights the need to reduce inequalities (SDG 10) in access to advanced medical technology.
3. Diagnosis: A biopsy confirmed a diagnosis of early-stage invasive ductal carcinoma, detected before any physical symptoms manifested.

Treatment Protocol and Public Health Implications

Comprehensive Treatment Strategy

The subject’s treatment plan reflects a multi-faceted approach to cancer care, aimed at ensuring long-term health and reducing the risk of recurrence, in line with SDG 3.

• Surgical Intervention: A bilateral mastectomy was performed as a preventative measure to minimize the probability of future cancer development.
• Systemic Treatment: A course of chemotherapy was administered, followed by a long-term (10-year) endocrine therapy regimen designed to significantly reduce the risk of recurrence.
• Personalized Care: The treatment plan was adjusted based on the patient’s reaction to chemotherapy, illustrating the importance of responsive and individualized healthcare.

The Critical Impact of Early Detection on SDG 3.4

Data from the National Breast Cancer Foundation reinforces the life-saving importance of early diagnosis, which is central to reducing premature mortality from NCDs.

• Early-Stage Survival Rate: 99% (five-year survival)
• Advanced-Stage Survival Rate: 32% (five-year survival)

This stark contrast validates the public health imperative for systems that facilitate early detection, particularly for high-risk populations.

Recommendations for Advancing Global Health Goals

Strengthening Health Systems for SDG 3, 5, and 10

Expert recommendations emphasize a shift towards personalized and preventative healthcare to achieve global health targets. This requires a multi-stakeholder partnership (SDG 17) between patients, providers, and public health organizations.

• Promote Risk Awareness: Educate individuals, particularly women, about understanding their personal risk factors, including family history, starting in their mid-20s.
• Develop Tailored Screening Plans: Move beyond generalized guidelines to provide high-risk individuals with access to early and more frequent screenings, including mammograms and MRIs. This addresses health inequalities (SDG 10) and promotes gender-specific health needs (SDG 5).
• Empower Patient Advocacy: Encourage individuals to actively participate in their healthcare decisions and advocate for necessary screenings and treatments.
• Ensure Equitable Access: Work towards universal access to specialized clinics, genetic testing, and advanced diagnostic technologies to ensure that positive health outcomes are not limited by socioeconomic status.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses issues related to two Sustainable Development Goals:

1. SDG 3: Good Health and Well-being
   • This is the most direct SDG connection, as the entire article revolves around the diagnosis, treatment, and prevention of breast cancer, a major non-communicable disease. It discusses access to healthcare services, early detection, treatment options, and the importance of health awareness to ensure a healthy life and promote well-being.
2. SDG 5: Gender Equality
   • The article focuses on breast cancer, a disease that disproportionately affects women. It highlights the importance of women’s health and empowerment through self-advocacy. The protagonist, Michaela Del Barrio, actively “pushed to receive early screenings” and is praised for her “self-aware and self-advocating” actions, which is a form of empowerment in making crucial decisions about her own body and health.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s content, the following specific targets can be identified:

• Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
  • The article directly supports this target by emphasizing the critical role of early detection and treatment in preventing premature death from breast cancer. The narrative of Michaela Del Barrio, who was diagnosed with early-stage cancer due to proactive screening, illustrates how prevention (through screening) and treatment (surgery, chemotherapy) can significantly improve survival outcomes. The article states that early-stage invasive ductal carcinoma has a 99% five-year survival rate, which drops to 32% in the most advanced stage, underscoring the importance of early intervention to reduce mortality.
• Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
  • The story details access to a range of quality essential healthcare services. Michaela was able to visit a “high-risk breast clinic,” undergo a “risk assessment,” and receive advanced screenings like a “mammogram” and a “breast MRI.” Her subsequent treatment included an “ultrasound,” a “biopsy,” a “bilateral mastectomy,” “chemotherapy,” and “endocrine therapy,” all of which represent access to comprehensive and quality cancer care.
• Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights.
  • While not about reproductive rights in the traditional sense, this target is relevant as it encompasses women’s overall health and bodily autonomy. The article highlights the importance of women having access to information and services related to their specific health risks. Michaela’s story is a powerful example of a woman taking control of her health narrative, from insisting on early screening despite being told she was “too young,” to making informed decisions about her treatment, such as opting for a bilateral mastectomy to “limit her odds of the cancer returning.” This self-advocacy is a core component of empowerment in health matters.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions or implies several indicators that can measure progress:

• For Target 3.4 (Reduce mortality from NCDs):
  • Cancer survival rates: The article explicitly provides statistics that serve as an indicator. It states, “early-stage invasive ductal carcinoma has a five-year survival rate of 99%, but that number falls as the disease spreads. The most advanced stage of the cancer has a five-year survival rate of just 32%.” This data directly measures the effectiveness of early diagnosis and treatment in reducing mortality.
• For Target 3.8 (Universal health coverage):
  • Coverage of essential health services: The article implies this indicator by listing the specific services the protagonist accessed. These include: risk assessments at specialized clinics, early and advanced cancer screenings (mammograms, MRIs), diagnostic procedures (biopsies), and comprehensive treatment options (surgery, chemotherapy, endocrine therapy). The availability and accessibility of such services are a measure of health service coverage.
• For Target 5.6 (Universal access to women’s health services):
  • Women’s health literacy and self-advocacy: While not a formal UN indicator, this is strongly implied as a measure of progress. The article celebrates Michaela because she “did speak up for myself” and was “self-aware and self-advocating.” Furthermore, the recommendation for women to “begin speaking to their doctors in their mid-20s, and flag any family history of cancer” points to health education and awareness as a crucial tool for empowerment and better health outcomes.

4. Table of SDGs, Targets, and Indicators

Source: cbsnews.com