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The number of breast cancers is rising world wide: 2088000 in 2018 and 2833000 estimated in 2040 i.e. an 35%increase. This increase in number will concern mainly the LMIC (Low and middle Income Countries), like sub- saharian Africa where the rising control of malaria, HIV and tuberculosis is associated with a longer life and consequently an increase in the number of cancers. Facing these disparities how can we avoid to increase the gap between the patients living in rich countries and those living in the LMIC. Actually the number of cases does not correspond to the TNM classification. Technical and biological progress as well as Artificial Intelligence ( IA) developments allows more and more targeted approachs in all the aspects of breast cancer management. At the same time costs are dramatically increasing and ours Health systems are greatly concerned by the present and future costs.