Breast cancer in the global south and the limitations of a biomedical framing: a critical review of the literature

Abstract

Public health researchers are devoting increasing attention to the growing burden of breast cancer in low-and middle-income countries (LMICs), previously thought to be minimally impacted by this disease. A critical examination of this body of literature is needed to explore the assumptions, advantages and limitations of current approaches. In our critical literature review, we find that researchers and public health practitioners predominantly privilege a biomedical perspective focused on patients' adherence (or non-adherence) to 'preventive' practices, screening behaviours and treatment regimens. Cost-effective 'quick fixes' are prioritized, and prevention is framed in terms of individual 'risk behaviours'. Thus, individuals and communities are held responsible for the success of the biomedical system; traditional belief systems and 'harmful' social practices are problematized. Inherently personal, social and cultural experiences of pain and suffering are neglected or reduced to the issue of chemical palliation. This narrow approach obscures the complex aetiology of the disease and perpetuates silence around power relations. This article calls for a social justice-oriented interrogation of the role of power and inequity in the global breast cancer epidemic, which recognizes the agency and experiences of women (and men) who experience breast cancer in the global south.

Keywords: Breast cancer; LMICs; cancer; global health; global south; medical anthropology; medical sociology; public health.