Strengthening breast cancer services in Vietnam: a mixed-methods study.

Our study suggests that there is a need to strengthen lower levels of the Vietnamese health system in relation to the detection of breast cancer. Provision of some services such as clinical breast examination, advice on self-examination, and conducting ultrasound tests (supported with appropriate training and capacity-building of healthcare providers) at commune and district levels of the health system may reduce the overcrowding and service-delivery burden experienced in provincial and national-level hospitals. Empowering lower levels of the health system to conduct breast cancer screening, which is currently undertaken on an ad hoc basis through higher-level facilities, is likely to improve access to services for women.