{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:26Z","timestamp":1788416006152,"version":"build-2803163510"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011075","name":"David Geffen School of Medicine, University of California, Los Angeles","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007920","name":"University of Massachusetts Medical School","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Breast cancer is the leading cause of cancer mortality among women globally. Armenia has one of the highest breast cancer mortality rates in the world, with an age standardized mortality-to-incidence ratio of 0.41, indicating that two in five breast cancer patients die from the disease. The factors contributing to this disproportionate mortality burden are poorly understood. The present study utilized a validated survey across four high-capacity cancer facilities to produce a national gap analysis of breast cancer care in Armenia. We find that the tertiary facilities surveyed broadly possess the fundamental technological and personnel resources required for modern breast cancer care; however, it is apparent that challenges exist with early detection, timely diagnosis, and successful treatment. Based on these findings, policy considerations could prioritize breast cancer mortality reduction through early detection, establishment of a cancer registry, streamlining cancer care, and reducing the financial burden of care on patients.<\/jats:p>","DOI":"10.3389\/fonc.2026.1907028","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:22:25Z","timestamp":1788412945000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gap analysis of breast cancer care at tertiary facilities in Armenia"],"prefix":"10.3389","volume":"16","author":[{"given":"Ani","family":"Arzoumanian","sequence":"first","affiliation":[{"name":"University of Massachusetts Chan Medical School","place":["Worcester, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sione","family":"Markarian","sequence":"additional","affiliation":[{"name":"University of California Los Angeles David Geffen School of Medicine","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School","place":["Worcester, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Mastro","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School","place":["Worcester, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sira","family":"Jil-Agopian","sequence":"additional","affiliation":[{"name":"V.A. Fanarjian National Center of Oncology","place":["Yerevan, Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Duggan","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center","place":["Seattle, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marine","family":"Hovhannisyan","sequence":"additional","affiliation":[{"name":"Yerevan State Medical University, Department of Hygiene and Ecology","place":["Yerevan, Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Louis","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School","place":["Worcester, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shant","family":"Shekherdimian","sequence":"additional","affiliation":[{"name":"University of California Los Angeles David Geffen School of Medicine","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","unstructured":"Global Cancer Observatory: Cancer Today\n          \n          \n            \n              Ferlay\n              J\n            \n            \n              Ervik\n              M\n            \n            \n              Lam\n              F\n            \n            \n              Laversanne\n              M\n            \n            \n              Colombet\n              M\n            \n            \n              Mery\n              L\n            \n          \n          \n          2024"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001849","article-title":"Validation of an Eastern Armenian breast cancer health belief survey","volume":"3","author":"Tupper","year":"2023","journal-title":"PloS Glob Public Health"},{"key":"B3","unstructured":"Globam Country Details"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2024.1607029","article-title":"Breast cancer awareness and screening perceptions of women in Yerevan, Armenia","volume":"69","author":"Tupper","year":"2024","journal-title":"Int J Public Health"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30674-4","article-title":"Comparison of breast cancer and cervical cancer stage distributions in ten newly independent states of the former Soviet Union: a population-based study","volume":"22","author":"Ryzhov","year":"2021","journal-title":"Lancet Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.782581","article-title":"Overview of cancer control in Armenia and policy implications","volume":"11","author":"Bedirian","year":"2022","journal-title":"Front Oncol"},{"key":"B7","volume-title":"Global Health Expenditure Database","year":"2025"},{"key":"B8","unstructured":"Armenia to Provide Accessible Healthcare Across the Country With World Bank Support\n          \n          \n          \n          2024"},{"key":"B9","unstructured":"The Global Breast Cancer Initiative"},{"key":"B10","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1001\/jama.2023.26730","article-title":"Benefits of breast cancer screening and treatment on mortality","volume":"331","author":"Wheeler","year":"2024","journal-title":"JAMA"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00462-9","article-title":"National health system characteristics, breast cancer stage at diagnosis, and breast cancer mortality: a population-based analysis","volume":"22","author":"Duggan","year":"2021","journal-title":"Lancet Oncol"},{"key":"B12","unstructured":"Armenia - Country Partnership Framework for the Period FY25-FY29\n          \n          \n          Washington, DC\n          World Bank"},{"key":"B13","unstructured":"Physicians (per 1,000 people) \u2013 Armenia\n          \n          \n          World Bank Open Data"},{"key":"B14","unstructured":"Tanzania Breast Health Care Assessment 2017: An Assessment of Breast Cancer Early Detection, Diagnosis and Treatment in Tanzania\n          \n          \n            \n              Bishop\n              A\n            \n            \n              Duggan\n              C\n            \n            \n              Dvaladze\n              A\n            \n            \n              Cabanes\n              A\n            \n            \n              Kombe\n              D\n            \n            \n              Patel\n              S\n            \n          \n          Seattle, WA"},{"key":"B15","volume-title":"Sergipe 2018. 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