Standardising breast centres to improve breast cancer care in South Africa

Presenting at the ESMO Africa Summit, Dr Sarah Nietz, breast surgeon research lead at BIGOSA, outlined the strategy for establishing specialised breast centres tailored to the South African context. While high-income countries (HICs) achieve five-year breast cancer survival rates between 85% and 90%, South Africa exhibits a sharp contrast. Survival rates and quality of care are rarely measured in the private sector but are likely highly variable, whereas the public health system lags at 44%1. BIGOSA's approach is to move beyond simply acknowledging these gaps to focus on actively measuring and managing care, ultimately cultivating a system where early breast cancer treatment is not only achievable but also measurable and scalable2. This will be achieved by bridging the survival gap through a standardised and multidisciplinary care delivered through a network of structured breast centre3.

Dr Nietz relates the value of a holistic approach to breast care. “While we cannot always change a diagnosis, we can change the standard of care experienced by individuals. By combining centralised expertise with deep empathy, we ensure that every patient has access to world-class care and a journey defined by support.” Through research and a patient-first approach, BIGOSA aims to provide affected South Africans with the gold standard in Multidisciplinary breast care.

The establishment of breast cancer centres aligns with government policy, specifically the 2017 National Department of Health (NDoH) Breast Cancer Guidelines4, which explicitly called for the creation of these centres to consolidate currently fragmented care. Each breast centre will function as a dedicated healthcare unit, exclusively focused on the diagnosis, treatment, and long-term surveillance of breast cancer. By centralising multidisciplinary expertise and resources, breast centres will be better placed to improve patient outcomes, including survival rates, enhance adherence to clinical guidelines, optimise multidisciplinary treatment planning, and achieve greater cost efficiency5. Dr Nietz highlighted that “The initial phase involves developing at least eight breast centres over the next 30 months through a collaborative public-private network”. This network includes public sector institutions such as Charlotte Maxeke Johannesburg Academic, Chris Hani Baragwanath, and Groote Schuur Hospitals, alongside private facilities from the Mediclinic, LenMed, and Busamed groups6.

A New Chapter: Roche Joins as Founding Partner 

A significant milestone in this journey is the formal launch of the implementation phase, reinforced by Roche’s strategic investment as a key founding partner. Roche will support the necessary setup of the breast centre steering committee and the project’s central infrastructure. "Through our founding partner sponsorship in the BIGOSA breast cancer centres of excellence project, Roche is championing equitable, scalable healthcare solutions," says Samantha Naiker, the Disease Area Squad Lead Breast Cancer. She further adds that this innovative approach reinforces Roche's position as a trusted partner, building stronger stakeholder relationships, and creating meaningful value for patients and healthcare systems across Africa, strengthening our leadership in breast cancer through a unified Africa-wide approach. 

By shifting from an assumption of gaps to the active measurement and management of care, BIGOSA aims to foster a system in which breast cancer treatment is focused on creating affordable, reproducible care models for low- and middle-income settings, making high-quality care accessible to a broader patient population7 . This collective effort is a commitment to rewrite the breast cancer survival story across South Africa and serve as a blueprint for the African continent.