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Shyirambere Cyprien, MMED
Director of Oncology, Partners in Health/Inshuti Mu Buzima
Administrative Director, Oncology Program
Butaro Cancer Center of Excellence
Goal: To promote early detection of breast cancer and improve quality of care in low-resource communities in Rwanda.
Impact: Breast cancer outcomes are poor in countries with limited resources such as Rwanda. Drs. Shyirambere and Shulman and their colleagues have trained hundreds of clinicians in breast health care and provided breast exam screening to thousands of patients in four districts of Rwanda. Their efforts have led to a significant improvement in patient outcomes in an area where women have a much higher risk of dying of breast cancer.
What’s next: The doctors will continue to expand their program to other districts in Rwanda. They also plan to develop a mobile platform to help patients navigate the health care system to obtain timely care and to maximize any follow-up care. Lastly, they will continue to expand training in diagnostic breast ultrasound and hope to develop innovative virtual curricula to adapt to current travel restrictions.
In low- to middle-income countries with limited resources such as Rwanda, breast cancer outcomes are poor due to lack of screening and follow-up. As a result, women are more likely to be diagnosed with advanced breast cancer and may not receive quality treatment. By focusing on training and infrastructure, Drs. Shyirambere and Shulman are developing effective strategies to increase early detection and reduce time to treatment.
Full Research Summary
Research area: Creating infrastructure and training health care professionals to ensure that underserved women in Rwanda receive quality screening and treatment for breast cancer.
Impact: Breast cancer is a major public health concern in low- and middle-income countries such as Rwanda, where women have a much higher risk of dying from their disease. This is due partly to delayed and late-stage diagnoses. By focusing on training and infrastructure, Drs. Shyirambere and Shulman have developed effective strategies to integrate early detection services into the health care system in rural Rwanda and reduce time to treatment. They are now working to expand these efforts to reach more women and shape national cancer control policy.
Current investigation: The team has been developing a breast cancer early detection program in the remote districts of Rwanda.
What they’ve learned so far: The research team trained hundreds of Rwandan health care workers in ways to educate patients about breast cancer, perform high-quality breast exams, utilize ultrasound to identify those who may have cancer, and refer patients for timely diagnosis and treatment. So far, the program has provided clinical breast exam screening to thousands of patients and expanded into four districts in the country.
What’s next: Drs. Shyirambere and Shulman will continue to expand their program to other districts in Rwanda and evaluate the program’s impact on the health system and patients. They also plan to develop a mobile platform to help patients navigate the health care system to obtain timely care and to maximize any follow-up care. Lastly, they will continue to expand training in diagnostic breast ultrasound and hope to develop innovative virtual curricula to adapt to current travel restrictions.
Cyprien Shyirambere, MD is a pediatrician and currently serves as the Director of Oncology at Partners In Health Rwanda. He received a B.S. degree in General Medicine and Surgery and a MMed degree in Pediatrics at the National University of Rwanda, Butare, Rwanda. He has provided clinical care as well as administrative leadership at Butaro Cancer Center of Excellence (BCCOE) and in the Partner’s In Health national oncology program since 2013. He has been a key leader in the breast cancer early detection program, overseeing program implementation in Butaro and beyond. As a clinician focused on cancer care in Rwanda, he also has profound insights into cancer diagnosis and care in Rwanda. His research focus has been in examining the success and challenges facing a cancer program in rural, resource-limited areas. He has been working closely with Drs. Shulman and Pace and the Rwanda Biomedical Center since 2013 in a collaborative effort to increase breast cancer early detection in under-resourced areas of Rwanda.