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Breast cancer
Breast cancer is a significant health problem in the industrialized western world, where it is the most common form of cancer among women in North America and almost all of Europe. It is estimated that each year the disease is diagnosed in over one million women worldwide and is the cause of death in over 400,000 women.
Recent data identifies a substantial reduction in breast cancer mortality, which is probably due to improvements in diagnosis and treatment. Early detection, via breast cancer screening is a potentially important strategy for reducing mortality.
The clinical manifestations of breast cancer can range from a localised tumour to a widely metastatic neoplasm. Treatment options that may be considered are surgery, radiotherapy, cytotoxic chemotherapy and hormonal manipulation or endocrine therapy.
Treatment options for breast cancer are initially identified according to the stage of the disease. The final treatment regimen selected, following discussion with the patient will depend on many factors including menopausal status, hormone receptor status and treatment preferences.
The following information is an international resource for health care professionals with an interest in breast cancer. If you are a patient or carer, please go to CancerLine for patients
Breast cancer epidemiology
Breast cancer is the most common form of cancer in women, accounting for one in ten of all new cancer diagnoses and almost one in four female cancers. Each year, breast cancer is diagnosed in 1.1 million women around the globe. The annual worldwide incidence of breast cancer has almost doubled since 1975.
The incidence and prevalence of breast cancer increase with increasing age. Approximately 50% of breast cancers occur in women aged 50–64 years, with a further 30% arising in women over the age of 70 years.
Breast cancer risk factors and assessment
The etiology of breast cancer is multifactorial and includes environmental and genetic factors.
Social and demographic factors
Gynecologic and obstetric factors
Medical history
Family history
Diet
Genetic factors
Despite the ever-increasing list of factors shown to predispose or protect against breast cancer, many aspects of its risk assessment remain poorly understood. These include:
the magnitude of risk associated with each factor;
how the individual risk factors within a combination interact; whether multiple risk factors are additive or multiplicative;
the relative importance of risk factors in pre- versus post-menopausal women;
and whether risk factors remain constant over time.
Furthermore, no risk factor can be identified in around 40% of women who develop breast cancer, indicating that many of the contributory factors are as yet unknown.
These limitations notwithstanding, several models have been developed to help the assessment of breast cancer risk in clinical practice. They include the Gail model, which is based on the Breast Cancer Diagnosis and Demonstration Project, and a modified Gail model produced by the US National Cancer Institute (NCI) and the National Surgical Adjuvant Breast and Bowel Project (NSABP).
