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in the morning conference (10/21/25) – as a national strategy – a very welcome and necessary model of universal comprehensive breast cancer care was announced by the Ministry of Health, which contemplates: 1) health promotion with educational campaigns; 2) prevention of risk factors (obesity, sedentary lifestyle, alcohol/tobacco); 3) timely detection with breast self-examination from age 20 and biannual mammograms from age 40; 4) diagnosis with a biopsy if a lesion is detected, and 5) treatment with highly specialized care: surgery, chemotherapy or radiotherapy.
Before (morning conference 10/6/25), the President presented the appropriate project to initiate (during 2026) a “registration” to the National Health System, “according to what people say to see if their medical history can be shared between institutions”, and granting a “credential” to the right of IMSS, Issste and IMSS-Bienestar, with the “objective” that, in 2027, generate a scheme that allows a “good part” of the diseases to be treated in any of the institutions (communication from the Presidency of the Republic, 10/6/25).
Without entering into the heart of the challenge of an integrated health system (worker-employer quota), the project only hopes to expand a “good part of the diseases”, following specific agreements for the exchange or unilateral provision of services between institutions such as, for example, the Heart Attack Code.
The announced “comprehensive” breast cancer care model is added to this restricted list of diseases, although it should be noted that due to its presentation it is a basically preventive model, not a comprehensive one.
The model sheets shown by Dr. David Kershenobich in the morning conference at no time allude to universality. They are reduced to presenting it as a preventive strategy. Subsequently, Kershenobich explicitly refers to the expansion of the infrastructure: acquisition of a thousand mammograms and a thousand ultrasounds, plus the construction of 32 hospital units for cancer care – one per state – as well as the expansion of the network of comprehensive care centers from 42 to 62, but he never specifies universality. It only states, without ever specifying it, that “universal access to medical care for patients will be guaranteed.” But how will they be guaranteed?
Without a doubt, the preventive and diagnostic approach of the announced model is more than welcome, but the model does not document the indistinct and continuous inter-institutional care IMSS-Issste-IMSS-Bienestar-Pemex for the large population universe covered: 25.5 million women over 40 years of age, according to Kershenobich.
Furthermore, the offer of care, “regardless of the eligibility” of the population universe covered, is never finalized. The current IMSS-Issste-IMSS-Bienestar-Pemex inter-institutional segmentation table remains intact, in which each institution offers its package without achieving the status of a “universal” strategy. So much so that during the morning conference, the IMSS only highlighted “its consultations” (Strategy 2-30-100), while the Issste reported on “its works” and the IMSS-Wellbeing presented its “oncology hospital for women.”
For its part, the cost structure to finance it confirms the segmentation: 8 billion pesos divided between the IMSS: half and the remaining 4 thousand “are provided by the Mexican government through the Issste and the IMSS-Bienestar.” Although the IMSS-Issste resources are employee-employer quota.
Strictly speaking, universality only covers the preventive component of the model, because the presentation by the Secretary of Health omitted the central point to achieve the status of a truly comprehensive model: not only promotion, risk factors, timely detection and diagnosis, but, in treatment, specifying patient navigation, inter-institutional interchangeability and, above all, the continuity of these treatments, as offered by President Sheinbaun’s anticipated universal system project at the morning conference on October 21, 25.
The model also overestimates the impact of technology when it asks: “how can we do that?”, and answers: “with the entire digitalization process.” Given the historically underfunded budget of the institutional network, with severe operating difficulties for overwhelmed institutions, insufficiently equipped with health professionals, infrastructure, equipment, supplies and medicines, the model can lead to care that ends up falling on the already overburdened institutional health teams.
It is not, of course, a technocratic project, but rather it seeks genuine solutions to an enormous problem: attention with adequate times, but it comes from a team that designs top-down as the only way out – overvaluing the technological impact – on a sector that demands much more basic knowledge, which can compromise its opportunity and viability.
*UAM-X
