BIGOSA initiative seeks to fix treatment delays and strengthen breast cancer care system

In South Africa, surviving breast cancer is often less about the biology of the disease and more about the efficiency of the hospital's logistics.

While high-income countries boast a five-year survival rate of roughly 90%, the overall survival rate in South Africa’s public sector sits at a sobering 44%.

For Dr. Sarah Nietz, a leading oncologist and a key voice at the Roche Africa Press Day, this isn't just a statistic, it’s a call for a total systemic overhaul.

"The treatment care pathway for breast cancer is incredibly complex," Dr. Nietz explains.

"Whenever there is a breakdown in any of the treatment modalities, be it surgery, radiation or pathology, that is where you see the decrease in survival. That is what makes the system so vulnerable."

The six-month wait: Measuring the temperature of care

Dr. Nietz highlighted uncomfortable truths regarding recent crises in the South African system.

While radiation delivery in Gauteng has seen recent improvements, she noted that until just two weeks ago, patients at Charlotte Maxeke Johannesburg Academic Hospital were waiting up to six months just for pathology results.

"We have to be able to measure these system issues in real time," she said. "It’s nice to know five or ten years later that there was a problem, but we need that data now to direct advocacy and inform policy."

A new Blueprint: The BIGOSA Breast Centres

To combat these delays, the Breast Interest Group of Southern Africa (BIGOSA) is embarking on a landmark project: the creation of specialised Breast Centres.

Unlike European models, which often create "pockets of excellence" that can inadvertently widen the gap between the rich and the poor, the BIGOSA model aims to elevate the entire system.

"We want to find systems that elevate both public and private sectors," said Dr. Nietz. "None of the centres are perfect. We aren't being punitive; we are just measuring the temperature so we know where we stand and can improve from there."

The founding centres include:

Public Sector: Groote Schuur (UCT), Charlotte Maxeke (JHB), and Chris Hani Baragwanath.

Private Sector: Units including MediClinic Morningside, LenMed, Busamed, and others across Gauteng, the Western Cape and KZN.