The role of primary healthcare in breast cancer awareness, screening, and patient navigation for women in Pakistan
Breast cancer demands a dual response: addressing the gravity of disease itself and overcoming the lack of awareness, stigma, and misconceptions surrounding it. Cultural barriers, social taboos, and fear often keep breast health concerns “under the carpet,” preventing women from seeking timely medical care.
Women often hesitate consulting a physician, even when they might have noticed something concerning. By the time she arrives at a healthcare facility, she may have already lost valuable time. Delayed diagnosis can mean more complex treatment, greater financial and emotional burden, loss of productivity, and ultimately, loss of lives. Early detection, timely diagnosis, and appropriate treatment can significantly improve outcomes.
The burden in Pakistan is substantial. According to the International Agency for Research on Cancer (IARC), approximately 30,682 new breast cancer cases were recorded among Pakistani women in 2022, making it the country’s most common cancer among women. Pink Ribbon Pakistan reports approximately 90,000 new cases and more than 40,000 deaths annually.
Yet behind every statistic is a woman with a unique story and a challenging journey. The 2026 Breast Cancer Awareness theme, “Every story is unique; every journey matters,” reminds us that women need not only awareness but also accessible services and guidance throughout their care.
From Awareness to Action
Awareness campaigns are essential, but awareness alone is not enough. The real challenge is converting awareness into action. This is where primary healthcare (PHC) becomes critical.
PHC is often the first and often the only point of contact between a community and the healthcare system. When effectively connected with secondary and tertiary services, it can help overcome barriers to breast health and improve access to care.
PHC practitioners are uniquely positioned to educate women, address myths, recognize concerning symptoms and risk factors, conduct clinical assessments, and arrange appropriate diagnostic imaging, such as mammography or ultrasound, or specialist referral when indicated. They can provide guidance regarding the next steps instead of leaving these women to navigate the healthcare system alone.
Early Detection: The Power of First Contact
The World Health Organization’s Global Breast Cancer Initiative aims to reduce breast cancer mortality by 2.5% annually by 2040, potentially averting 2.5 million deaths through better early detection, timely diagnosis, and comprehensive treatment.
For Pakistan, achieving this goal requires action at the community level: trained frontline healthcare workers, accessible services, effective referral networks, patient navigation, and continuity of care.
Bringing the Mission to the Community: SINA HealthSystems Foundation
SINA HealthSystems Foundation, a not-for-profit organization serving underserved communities in Karachi’s urban slums, is committed to bridging the gap between awareness and action. SINA operates 40 clinics, delivering basic primary healthcare services across the city.
Since the start of 2026, SINA’s clinicians have educated more than 2,000 women on breast self-awareness, appropriate self-examination techniques, warning signs, and the importance of timely medical consultation. These sessions also address misconceptions that may discourage women from seeking care.
As a step towards early detection, a four-month pilot was launched at a single site, where 151 women were clinically screened by trained physician, and resulted in 12 referrals for further diagnostic or screening imaging.
The pilot highlighted practical barriers to screening, such as hesitation to undergo clinical screening and investigations without having symptoms, financial constraints, transport difficulties, limited family support, time pressures, or fear of delays and refusals at referral facilities. Moreover, lack of a proper system for referral at secondary and tertiary care levels creates a significant gap between primary care and access to imaging and diagnostics.
In light of these challenges, SINA strengthened its links with tertiary care facilities and improved navigation of referred women, by pre-coordinated guidance about referral site, time, prerequisites and contact person at imaging facility, making their diagnostic journey clearer and more manageable.
Scaling Up: From One Clinic to the Community
During Pinktober 2026, SINA is expanding Breast Cancer Awareness and Screening Program across its network. The program focuses on three priorities: changing mindsets, striving for early detection, and creating pathways to action.
Women participate in breast health awareness sessions, while men visiting the clinics are also sensitized to the importance of early detection. Men’s awareness is crucial to women’s healthcare decisions, finances, transport, and emotional well-being.
Frontline clinicians across SINA are engaged in breast cancer screening through relevant history-taking, risk assessment and clinical breast examination, making appropriate imaging or specialist referrals when indicated.
“Breast Health Ambassadors” are being assigned at each clinic to guide women through referrals and follow up on recommended investigations. This will assist PHC teams to review results, determine the need for specialist evaluation, and reduce the risk of women being lost to primary and specialist care.
At SINA Health Systems Foundation, “Educate. Detect. Act.” is more than a Pinktober message. It is an ongoing commitment to reach more women and help ensure that awareness leads to timely action.
The author is Training and Supervision Lead, Medical Affairs Department, SINA HealthSystems Foundation