Dr. José Cotrina, who directs the Department of Breast Surgery and Tissue at Peru's INEN cancer institute, says the country is still falling short on detecting breast cancer early. He points to a persistent gap in access to prevention services, one that is widest in remote areas far from the main cities. Women in those regions must travel long distances for a mammogram, and many never manage the trip at all. Fear plays its part too, since some patients avoid examinations rather than face the possibility of a bad result. Delayed testing usually means tumors are caught at later stages, when treatment is harder and survival odds worsen. INEN, as the national referral hospital for cancer, sees the cost of late detection in its own wards. Cotrina's remarks press the point that geography and dread, more than medicine, stand between many Peruvian women and an early diagnosis.