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Background: A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease.Methods: The Breast Health Global Initiative (BHGI) held its 3rd Global Summit in Budapest, Hungary from October 1-4, 2007, bringing together internationally recognized experts to address the implementation of breast health care guidelines for early detection, diagnosis and treatment in low-and middle-income countries (LMCs).Results: Public education and awareness is a key first step, because early detection cannot be successful when the public is unaware about the value of early detection in saving the lives of women through downstaging of the disease at diagnosis.While mammographic screening is the gold standard for early detection of breast cancer, considerations regarding cost-effectiveness and quality assurance of such a program in LMCs is a concern.The preponderance of the evidence suggests that in most countries it would be reasonable to begin a breast cancer screening program by offering mammography every 2 years to women between the ages of 50 and 65.The efficacy of breast self-examination in reducing mortality from breast cancer has not been confirmed in two randomized trials.Currently, the evidence is not sufficiently conclusive to justify the recommendation for routine CBE in population-based screening programs..Social and cultural barriers must be considered in any context where early detection programs are being established.Barriers to early detection of breast cancer are often at the level of the individual woman, including fear of cancer, fear ofmastectomy, lack of financial resources, placing family above their own needs, and requiring spousal consent for action.For a large number of women, especially in male dominated societies, which prevail in the LMCs, their greatest fear is that their husbands may abandon them.Evaluation: The ultimate aim will be to downstage disease at diagnosis, hence leading to an improvement in breast cancer outcomes.Conclusion: The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis, and will drive the breadth of resource allocation needed for program implementation.