Cheng-Har Yip, MB, BS, FRCS of Breast Surgery International, Malaysia discusses the challenges in the management of breast cancer in low and middle income countries at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Dr Yip explains that the incidence of breast cancer is lower in developing countries but increasing rapidly. Further, women present with late stages of breast cancer; more than 50% of women present with stage 3 and 4. She explains that mortality in low and middle income countries is high. The issue is access to optimal treatment as there are not enough healthcare professional or facilities. In order to lower the high mortality rates, it is important to know why women present late. They conducted a qualitative study in Malaysia to find out and reasons include fatalism, belief in alternative therapies, poor decision-making, and financial problems.