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Breast Cancer is the most common female cancer worldwide with significant global disparities, particularly disadvantaging women of African Ancestry. Though the United States and Sub-Saharan Africa are seemingly very different settings, there are many important parallels between the experience of getting diagnosed and treated for breast cancer in these two geographic regions for women of African ancestry. This commentary explores the parallels and differences and proposes an agenda to move forward to narrow the disparities gaps for some of the worlds most vulnerable women., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: Despite the increasing burden, breast cancer control in sub-Saharan Africa is insufficient. Late diagnosis and lack of early detection and screening services contribute to high mortality. Clinical breast exam (CBE) screening can be valuable in low-income countries, including use of community health workers and non-health professionals to conduct exams. We assessed experiences of women who underwent CBE screening by trained laywomen in Lilongwe, Malawi, as part of a pilot program., Methods: The pilot study invited women attending urban health clinics to a breast cancer educational talk followed by CBE screening by trained laywomen. We purposively sampled participants from the pilot study and interviewed them about the screening experience and future cancer education programs and services., Results: Overall participants had positive experiences and were willing to undergo CBE screening by trained laywomen. Participants were motivated by the educational talk, shared newly acquired cancer knowledge with their social networks, and encouraged others to seek screening. Screened women suggested strategies for future interventions including combining breast and cervical cancer screening, using female providers, partnering with community leaders to increase uptake, and expanding services into the community., Conclusions: Asymptomatic Malawian women accepted CBE screening by trained laywomen and considered breast cancer an important health issue. Women appreciated combined education and screening services and proposed further linkage of breast and cervical cancer screening. Based on our results, training laywomen to educate the public on breast cancer and conduct CBE is a feasible breast cancer control strategy in sub-Saharan Africa.