Armenia's transition to a democratic, market-based society began with its independence from the Soviet Union in September 1991. The collapse of the Soviet economy, combined with the impact of the severe 1988 earthquake, left post-Soviet Armenia in economic shambles. Preventative medicine had been non-existent in Soviet Armenia, and the already limited government-supported healthcare system was totally crippled by the collapse of the USSR. In 1996 Armenia's Minister of Health identified breast cancer as the nation's leading cause of cancer deaths among women, but Armenia was incapable of addressing its breast cancer crisis.