Recruiting committed representatives from as many countries as possible, particularly low and middle income countries, will ensure the success of the NCBC International Delegate Program. The NCBC, therefore, invites its entire Membership to email to the NCBC International Liaison Committee via the names and coordinates of any worthy international candidates who will agree to share their experiences, expertise and explore possible joint solutions with the NCBC to improve international breast care.



John Keyserlingk, MD, MSc, FRCS, FACS
Chair, NCBC International Liaison Committee
Surgical Oncologist & Medical Director
VM Breast and Oncology Center
Montreal, Quebec, Canada

The “State of Oncology 2013” report by the International Prevention Research Institute [IPRI] warns that the global number of new cancer cases will have doubled between 2008 and 2030. By that time, the annual death toll would reach 17 million with the vast majority coming from low- and middle-income countries – and many would be victims of absent, or delayed access to, breast cancer care. The IPRI report emphasizes that improving access to better breast cancer management in developing countries will be a daunting task. This endeavor will require, in addition to major funding, committed partnerships among medical organizations, foundations, pharmaceutical and technology companies.

The NCBC has long been recognized as the premier organization promoting truly interdisciplinary care as both the ultimate and the essential model to optimize breast cancer prevention, detection, management, and rehabilitation. NCBC, with over 1,000 individual members and approximately 450 breast center members, now stands ready to respond to this urgent international appeal by sharing its collective expertise with its international colleagues still facing often insurmountable obstacles.

In order to clarify the different levels of international membership, we have developed the following definitions:

1. An NCBC International Member is an already active and paid member of the NCBC who resides outside of the USA and Canada

2. An NCBC International Delegate is actively involved with breast care delivery outside of the USA and Canada, and has been proposed to, and accepted by, the International Liaison Committee to   serve as an NCBC International Delegate (ID). In recognition for accepting the ID mandate, primarily to increase the NCBC membership’s awareness of international Breast Cancer care (see below),   they will receive a complementary two-year membership, and are also eligible to compete for the 5 funding awards to attend the annual NCoBC Conference in Las Vegas March 15-19, 2014, as a sponsored International Delegate

3. A Sponsored NCBC International Delegate has competed and been selected for one of the five awards providing funding to attend the annual NCoBC Interdisciplinary Breast Center Conference. Sponsored International Delegates will have certain additional responsibilities (see below), including presenting a poster for the annual conference, participating in a plenary panel during the conference on International Breast Care, and helping the NCBC to raise funding to sustain this program for future IDs and help improve breast care where it is most needed.

The purpose of this International Delegate Program is to promote awareness and explore feasible solutions to global breast care challenges. The following three-part mission, approved by the NCBC Board of Trustees, is sequential.

• Promote Awareness within the NCBC Membership of Breast Care Challenges in Underserved Countries. International Delegates will be given the mandate to describe vis-à-vis various formats [e.g., NCBC newsletter and conference] the increasing breast care challenges, obstacles and potential solutions experienced by the international community particularly, but not exclusively, in low- and middle-income countries. These venues would offer NCBC members a unique, first-hand “grass roots in the trenches” window on the tangible problems in the international community. This cross-pollination between the membership and Delegates would promote optimal awareness.

• Share and Export NCBC Programs and Expertise. Among the educational initiatives that could have an impact in countries where access is compromised are the following:
Patient Navigation
Breast Self Examination
Clinical Breast Examination Training
Select Quality Metrics: e.g.: National Quality Measures for Breast Centers (NQMBC)
Breast Center Development Programs
Newsletter and Web Resources

Any of these initiatives or other NCBC-related expertise that are deemed by the International Delegates as pertinent and applicable to the international community can then be transferred, with NCBC’s assistance, to those countries for accelerated implementation.

• Seek External Funding. The numerous external sources of funding and other support will be critical. Depending on the source, each will donate knowledge, expertise, training, educational materials, medicines, and/or technology in order to provide the necessary progress with the shortest delay. It is understood that the International Delegates would agree to assist NCBC to intercede with those agencies and organizations with stated priorities to improve global breast care. This process is intended to sustain and enhance a fertile exchange of ideas and realistic solutions.

The entire NCBC membership is vigorously invited and encouraged to propose new International Delegates from any country other than the US and Canada, even from those countries that already have designated or proposed NCBC International Delegates (Argentina, Australia, Brazil, Dominican Republic, Ghana, India, Jordan, Kosovo, Mexico, Oman, South Africa, and the UAE). The NCBC is interested in recruiting International Delegates from as many countries as possible, with special emphasis given to those Delegates from low- and middle-income countries where its involvement could expect to have the greatest positive impact on the rapidly increasing international breast cancer burden.

• Who is eligible to become an NCBC International Delegate? Proposed candidates for Delegate status could be physicians, nurses, technologists, administrators, educators, researchers, government regulators, etc., and should be proposed by the NCBC Membership and selected by the International Liaison Committee based on their specific expertise and commitment to optimize breast cancer care in their respective countries. Their involvement could be in clinical care, education and/or breast care policy design and implementation, etc. They must also be willing to share their breast care experiences, obstacles and successes with the entire NCBC Membership. Crucial information regarding possible International Delegate candidates, including their coordinates and how they are involved with breast care , should be sent to ASAP, so these proposals may be reviewed by the International Liaison Committee for approval, followed by an invitation to join the current list of NCBC International Delegates. Details are discussed below.

• Benefits of being an NCBC International Delegate. All selected Delegates will be offered a 2-year free NCBC membership and encouraged to attend the Annual NCBC Interdisciplinary Breast Center Conference in Las Vegas, March 15 -18, 2014. They will also be eligible to compete for one of five NCBC 2014 International Delegate Annual Conference Awards. These awards, with a maximum amount of $2800, are supported by a limited and targeted international stimulus fund, and will cover airfare, ground expenses, full conference registration, and room and board at the host hotel (Caesar’s Palace) for the duration of the 2014 Conference for five Delegates. Preference will be given to Delegates from low- and middle-income countries and/or who could not otherwise afford to attend. NCBC Members wishing to propose a Delegate who could compete for these five awards need to send in the names of their candidate to Wendy Anderson at by December 27th 2014 so that their candidate can be both accepted as a Delegate, and also have sufficient time to submit their Conference funding proposal by the January 10th 2014 due date.

• Competitive Process. Those Delegates wishing to compete for one of the five NCBC 2014 International Delegate Annual Conference Awards will be requested to submit a 500 to 1,000-word proposal to the NCBC by January 10th, 2014.

The written proposal from competing Delegates should include the following:
• Describe their professional status and their country of origin.
• Outline their current practice, goals, challenges, successes and any other pertinent breast cancer related information.
• Describe their plans to resolve specific obstacles that currently impede optimal access for patients to best possible breast care.
• Explain how accessing the NCBC membership expertise and programs, as well as participating in the annual conference, could potentially help attain their stated goals.

As Conference Registration is complementary, and set stipends will be provided for ground fare and room and board during the Conference, competing Delegates must indicate if they have access to any other funding for air travel, as well as the cost of the best available return airfare to determine what portion of the maximum $2800 would be required to attend the 24th Annual Interdisciplinary Breast Center Conference from March 15th to 19th 2014 in Las Vegas.

• Selection Process. The proposals will be evaluated by the International Liaison Committee(1) [ILC]. The selection process will be based on an objective grading scale that includes country of origin, their challenges and/or solutions, their possible involvement with breast care policies and delivery and their ability and interest in sharing this information with the entire NCBC membership. These proposals may also be selected by the NCBC Newsletter Editorial Board for publication to enhance NCBC membership awareness of breast care obstacles in underserved countries. The five successful recipients, who become Sponsored NCBC International Delegates, will be informed by January 16th, 2014 in order to provide sufficient time for travel arrangements. Competing Delegates who anticipate possible visa-related problems should advise Wendy Anderson, the NCBC International Liaison Committee coordinator, by email as soon as possible so that these issues can be addressed well in advance should the candidate be awarded funding.

• Sponsored NCBC International Delegate Responsibilities and Rewards. The five 2014 Annual Interdisciplinary Breast Center Conference Award recipients will be expected to submit a Conference Poster describing the challenges and solutions to improve breast care in their respective countries. They, along with any other International Delegate attending the Conference, will be briefly introduced to the entire NCBC Board of Trustees at its annual meeting, Saturday evening, March 15th. The five Award recipients will also participate in a special accredited plenary Panel Presentation on March 16th during the opening day of the annual conference. The panel is entitled Current Challenges in International Breast Care Delivery.

Arrangements will also be made to facilitate International Delegate networking during the Conference with NCBC members who would be interested in getting involved with international breast care. Special meetings will also be set up to introduce the Delegates to on-site foundation, industry, and pharmaceutical representatives to discuss, explore and help the NCBC secure funding for the 2015 Annual Conference Awards, to help launch the proposed NCBC Mini-Fellowship program (see below) , and to facilitate solutions in those countries where improving breast care is most urgent


As an additional academic and training incentive for the NCBC International Delegates, the NCBC is proposing to launch a NCBC Mini-Fellowship Program by June 2014 that would coincide with the 2015 NCoBC Annual Interdisciplinary Breast Center Conference. This new program is dependent on the ability to raise the needed additional funding.

This second International Program would provide targeted funding for two additional NCBC Delegates to spend 2-4 weeks as a Visiting NCBC International Delegate/Fellow at one of the participating NCBC Breast Centers of their choice prior to proceeding on to the 2015 NCoBC Annual Interdisciplinary Breast Center Conference in Las Vegas, alongside the five 2015 Annual Conference Awards recipients. Assuming that there will be sufficient funding for this important educational opportunity, the International Liaison Committee will be canvassing the current NCBC Breast Centers to establish a list of those breast centers that would volunteer to facilitate such a Mini-Fellowship.

By setting the missions and promoting these different initiatives, the NCBC has made a significant, tangible and possibly unique commitment to increasing its membership’s awareness of the numerous challenges involved with global breast care, and to explore how the extensive NCBC expertise could help resolve them.

1.International Liaison Committee: Drs. John Keyserlingk, Yuri Parisky, Ernie Bodai, Sangeeta Sandhu, Tarek Hijal, Gordon Brabant, Michael Thirwell, Naim Otaky, Jay Parikh, and Don Dizon.