Doubts have been raised over efforts to bring in population-based mammography screening to poorer countries.
Breast cancer is the most common cancer in women, and screening programmes are regularly used in high-income countries.
But, writing in the Lancet, Dr Joe Harford of the National Cancer Institute, Bethesda, USA, argues that widespread screening would often be an ineffective use of limited resources in low-income and middle-income countries.
Rates of breast cancer are generally lower in these countries, Dr Harford states, so screening programmes would be less cost-effective. Participation rates and compliance with treatment are also likely to be lower.
He calls for a greater focus on women who already have symptoms. "Resources in these countries might be better used to raise awareness and encourage more women with palpable breast lumps to seek and receive treatment in a timely manner," he concludes.
* Women smokers face an increased breast cancer risk, researchers warn today.
Dr Juhua Luo of West Virginia University, USA, and colleagues looked for a potential association using figures on 79,990 post-menopausal women followed for about a decade. Of the women, 3,520 developed invasive breast cancer.
Compared with women who had never smoked, breast cancer risk was raised by nine per cent among former smokers, and 16 per cent among current smokers. Risk was raised for about 20 years after a smoker had quit.
Those who started smoking earlier, and smoked more per day, were at the highest risk. The researchers also report evidence of a link between "extensive exposure to passive smoking" and increased risk of breast cancer.
"However, the association between passive smoking and breast cancer should be considered suggestive only," they conclude.
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