Breast cancer represents the most prevalent malignancy among women in Oman, imposing considerable psychosocial and cultural burdens on both patients and their families. Understanding the lived experiences of affected women is essential for designing culturally appropriate psycho-oncological care.This qualitative study aimed to investigate the psychosocial and cultural dimensions of breast cancer among Omani mothers, concentrating on emotional trajectories, treatment decision-making, illness disclosure, and coping mechanisms within the family and community context.Six main themes emerged: (1) the diagnostic journey and pathways to care; (2) emotional responses to diagnosis and shifting adaptation over time; (3) treatment experiences and decision-making influenced by trust, family authority, and cultural expectations; (4) illness disclosure and communication strategies; (5) family and community responses to the diagnosis; and (6) coping strategies grounded in faith, patience, and behavioral adjustment.The findings highlight how women's experiences are profoundly shaped by familial roles, social stigma, and religious interpretations of illness. Culturally ingrained patterns of disclosure and reliance on familial support significantly influence women's adjustment and engagement with healthcare.The integration of psychosocial support and culturally sensitive communication practices into cancer care is crucial for enhancing patient well-being and strengthening family involvement in treatment and recovery. Keywords: breast cancer, phenomenology, culture, disclosure, coping mechanisms.

The FASTRACS intervention supports women with breast cancer in preparing for their return to work (RTW), using tools designed for the patient, the general practitioner, the occupational physician and the company representative, in order to promote long-term job retention. Due to the diversity of its components, stakeholders and implementation contexts, FASTRACS is a complex intervention.The RECOVA-FASTRACS study aims to conduct a realistic evaluation of the programme in order to understand how, for whom and under what conditions it works.RECOVA-FASTRACS is an ancillary study to the FASTRACS-RCT using convergent mixed methods, based on a multiple case study approach. The process follows four stages:(1) reconstruction of the initial theory; (2) collection of qualitative and quantitative data; (3) analysis according to the ICAMO framework (Intervention, Context, Actors, Mechanisms, Outcome) framework); (4)  refinement of the theory through triangulation. Data collection includes: interviews with women in the intervention arm and their "trajectory" actors (doctors, referrers, relatives); focus groups with the professionals involved; and analysis of the RCT questionnaires.The initial theory identified the expected causal chains for the 45 performance objectives.Sixty-four interviews were conducted. Initial results show that the patient guide helped to anticipate recovery and structure the RAT process by encouraging the expression of needs and the mobilisation of the actors concerned. Analysis of user profiles suggests different levels of uptake: human resources professionals made particularly good use of it, while healthcare professionals and people who described themselves as independent used it less.This return-to-work intervention involving the pivotal role of the general practitioner appears to be effective. This work opens up the prospect of research into the city-hospital link and the issue of job retention in chronic diseases.FASTRACS appears to be a tool that promotes positive thinking and behaviour for a suitable return to work.

In 2024, the USPSTF revised mammography screening recommendations, lowering the starting age from 50 to 40 years. This change was based on modeling studies rather than new clinical trials, prompted by higher breast cancer mortality among Black women in the US and a 2% increase in breast cancer incidence in women aged 40-49 during 2015-2019. XXX and many European countries have different genetic diversity profiles and haven't shown similar increases in this age group. In addition, they did not include a cost-effectiveness analysis.To evaluate the clinical and economic impact of adopting the revised 2024 USPSTF mammography screening guidelines in XXX by: 1. Comparing breast cancer cases, deaths, and quality-adjusted life years (QALYs) between two strategies - starting screening at age 40 versus 50. 2. Estimating the associated costs and cost-effectiveness of each strategy in the XXX healthcare context. 3. Assessing whether lowering the screening age provides sufficient benefit to justify the economic burden, to help decision makers.We constructed a decision analytic model comparing breast cancer screening for women aged 50-74 years versus 40-74 years, reflecting XXX epidemiology, life expectancy, and costs across four major subpopulations. We estimated breast cancer cases, deaths, costs, and resource demands.Starting screening at age 40 compared to age 50 averted 1.3 breast cancer deaths per 1000 women screened. The QALY gain was 0.037 with an additional cost of 21,000 XXX, resulting in an ICER of 567,567 XXX/QALY—significantly higher than XXX's willingness-to-pay threshold of 139,000 XXX (=GDP per capita).Our analysis suggests that adopting the new USPSTF guidelines in XXX would not be cost-effective. The small clinical benefit does not justify the substantial economic burden on the healthcare system. XXX's unique population demographics and breast cancer epidemiology differ from the US, warranting country-specific screening policies rather than automatic adoption of international guidelines.We recommend maintaining the current practice of initiating routine mammography screening at age 50 for the general XXX population.

In 2022, breast cancer remained the leading cancer among women in terms of both incidence and mortality. In France, the 2015 citizen consultation revealed a strong demand from women for better information on primary prevention.This study aimed to synthesize current evidence on breast cancer risk factors, to inform both women and healthcare professionals involved in prevention.An umbrella review was conducted following the Joanna Briggs Institute (JBI) methodology, including systematic reviews and meta-analyses published between 2015 and 2025, in french or english. Data were extracted and assessed independently by two reviewers, and the methodological quality of the reviews was appraised using the AMSTAR 2 tool.Of the 364 records identified, 10 reviews were included, 7 of which were of moderate to high quality. Western diets high in red meat and processed foods, along with alcohol consumption, were associated with an increased risk of breast cancer. A diversified diet rich in fruits, vegetables, and whole grains appeared protective. Postmenopausal overweight increased risk, while physical activity reduced it. Combined estrogen-progestin or progestin-only contraceptives were not clearly linked to breast cancer risk, unlike estrogen-only therapies and hormone replacement therapy. Nulliparity and late first pregnancy increased the risk, whereas breastfeeding was protective.Dietary habits, sedentary lifestyle, alcohol intake, nulliparity, and age at first pregnancy were identified as "discussed" risk factors by the French National Authority for Health (HAS). Smoking was not considered a breast cancer risk factor by the HAS due to a relative risk below 1.1.This work could be complemented by a broader umbrella review exploring the role of the exposome, particularly environmental exposures.

Timely breast cancer (BC) diagnosis is crucial for improved outcomes, yet delays remain prevalent worldwide. In high-income countries, diagnostic delays arise from multiple systemic factors, while in Africa, mortality rates are highest due to prolonged diagnostics .This abstract describes 2 scoping reviews on diagnostic delays in BC among women, comparing contributing factors across different healthcare and sociocultural settings.Following PRISMA-ScR guidelines, we conducted 2 global scoping reviews of diagnostic delays in BC (qualitative and quantitative studies) published between 2018 and 2023. Searches were performed in PubMed/MEDLINE and Scopus. Studies focused solely on screening, non-English and those not meeting inclusion criteria were excluded. Two reviewers independently screened and extracted data. Bronfenbrenner’s ecological model was applied to classify factors at the micro, meso, exo, and macrosystem levels.Of the 9699 retrieved records, 128 studies met inclusion criteria, with 22 focusing on high-income countries and 30 on African countries. In high-income settings, diagnostic delays were linked to microsystem (health behaviors, psychological factors, provider interactions), mesosystem (peer networks, scheduling), exosystem (social and environmental barriers), and macrosystem (policy and cultural influences) factors. In Africa, delays were largely attributed to low awareness, cultural beliefs, financial barriers, reliance on traditional healers, and healthcare inefficiencies.Although diagnostic delay is a global issue, the underlying mechanisms differ substantially by context. High-income settings are characterized by complex interactions between individual help-seeking behavior and health system organization. In contrast, structural and sociocultural barriers play a dominant role in African settings. These findings suggest that effective interventions must align with contextual realities: strengthening navigation and communication pathways in high-income countries, and improving community-level awareness, affordability, and system capacity in African countries.Diagnostic delays in BC are multifaceted with distinct patterns across settings. Context-specific, multi-level interventions, improving access, addressing cultural beliefs, and enhancing system responsiveness are essential to support timely diagnosis. Future research should prioritize tailored strategies that reflect the ecological environments in which women seek care.

Mammography is the cornerstone of breast cancer screening. Its diagnostic performance, however, is influenced by population demographics such as age and breast density.The purpose of this study was to establish contemporary performance benchmarks for mammography in the PHC system and to assess screening performance trends over time. Estimates were based on standardized reporting and longitudinal verification, offering a more robust benchmark for future quality-improvement efforts.A cross-sectional retrospective analysis was performed on mammograms from asymptomatic women aged ≥40 years who were screened in 2020 at the primary health care centres. Screening outcomes were cross-referenced with subsequent breast cancer diagnoses recorded in the Cancer Registry. The performance metrics including the cancer detection rate (CDR), sensitivity, and specificity were calculated.A total of 2,196 screening mammograms were included, with a mean patient age of 56.1 years. The cancer detection rate was 12.3 per 1,000 screens, and the recall rate was 30.6%. Sensitivity and specificity were 69.2% and 71.2%, respectively, and the interval cancer rate was 5.4 per 1,000. The most common breast density category was “scattered fibroglandular” (61.8%). Recall rates were significantly associated with breast density (p < 0.001). Among the 39 patients diagnosed with breast cancer, invasive ductal carcinoma was the most prevalent subtype (71.8%).Our findings are generally consistent with the range of results reported in the literature, though certain metrics differ in magnitude.One of the limitations is the screening population’s relatively younger age and greater breast density likely reduced the observed sensitivity and specificity of mammography, potentially underestimating the true cancer detection rate.The findings highlight the moderate utility of mammography screening in Primary Health Care Centers, characterised by a relatively high recall rate and a need to optimise reporting standards and recall criteria. Tailored strategies such as supplemental imaging for women with dense or high-risk breasts, strict adherence to BI-RADS guidelines, and implementing double reading or single reading with computer-aided detection could improve screening outcomes. These results establish important regional performance benchmarks. Empowering women to make informed choices about screening (reflecting the principle of liberty) can together enhance participation, trust, and effectiveness of national screening programs.