Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen , shortness of breath, or yellow skin.
Risk factors for developing breast cancer include obesity, a lack of physical exercise, alcohol consumption, hormone replacement therapy during menopause, ionizing radiation, an early age at Menarche, having children late in life (or not at all), older age, having a prior history of breast cancer, and a family history of breast cancer.
Breast cancer screening can be instrumental, given that the size of a breast cancer and its spread are among the most critical factors in predicting the prognosis of the disease. Breast cancers found during screening are typically smaller and less likely to have spread outside the breast. Training health workers to do clinical breast examination may have potential to detect breast cancer at an early stage. A 2013 Cochrane review found that it was unclear whether screening does more harm than good, in that a large proportion of women who test positive turn out not to have the disease. A 2009 review for the US Preventive Services Task Force found evidence of benefit in those 40 to 70 years of age, and the organization recommends screening every two years in women 50 to 74 years of age. The medications tamoxifen or raloxifene may be used in an effort to prevent breast cancer in those who are at high risk of developing it. Surgical removal of both breasts is another preventive measure in some high risk women. In those who have been diagnosed with cancer, a number of treatments may be used, including surgery, radiation therapy, chemotherapy, hormonal therapy, and targeted therapy. Types of surgery vary from breast-conserving surgery to mastectomy. Breast reconstruction may take place at the time of surgery or at a later date. In those in whom the cancer has spread to other parts of the body, treatments are mostly aimed at improving quality of life and comfort.
Outcomes for breast cancer vary depending on the cancer type, the Cancer staging, and the person's age. The five-year survival rates in England and the United States are between 80 and 90%. In developing countries, five-year survival rates are lower. Worldwide, breast cancer is the leading type of cancer in women, accounting for 25% of all cases.
Some less common forms of breast cancer cause distinctive symptoms. Up to 5% of people with breast cancer have inflammatory breast cancer, where cancer cells block the of one breast, causing the breast to substantially swell and redden over three to six months. Up to 3% of people with breast cancer have Paget's disease of the breast, with eczema-like red, scaly irritation on the nipple and areola.
Advanced tumors can spread (metastasize) beyond the breast, most commonly to the bones, liver, lungs, and brain. Bone metastases can cause swelling, progressive bone pain, and weakening of the bones that leads to bone fracture. Liver metastases can cause abdominal pain, nausea, vomiting, and skin problems – rash, itchy skin, or yellowing of the skin (jaundice). Those with lung metastases experience chest pain, shortness of breath, and regular . Metastases in the brain can cause persistent headache, , nausea, vomiting, and disruptions to the affected person's speech, vision, memory, and regular behavior.
A mammogram also reveals breast density; dense breast tissue appears opaque on a mammogram and can obscure tumors. BI-RADS categorizes breast density into four categories. Mammography can detect around 90% of breast tumors in the least dense breasts (called "fatty" breasts), but just 60% in the most dense breasts (called "extremely dense"). Women with particularly dense breasts can instead be screened by ultrasound, magnetic resonance imaging (MRI), or tomosynthesis, all of which more sensitively detect breast tumors.
Regular screening mammography reduces breast cancer deaths by at least 20%. Most medical guidelines recommend annual screening mammograms for women aged 50–70. Screening also reduces breast cancer mortality in women aged 40–49, and some guidelines recommend annual screening in this age group as well. For women at high risk for developing breast cancer, most guidelines recommend adding MRI screening to mammography, to increase the chance of detecting potentially dangerous tumors. Regularly feeling one's own breasts for lumps or other abnormalities, called breast self-examination, does not reduce a person's chance of dying from breast cancer. Clinical breast exams, where a health professional feels the breasts for abnormalities, are common; whether they reduce the risk of dying from breast cancer is not known. Regular breast cancer screening is commonplace in most wealthy nations, but remains uncommon in the world's poorer countries.
Still, mammography has its disadvantages. Overall, screening mammograms miss about 1 in 8 breast cancers, they can also give false-positive results, causing extra anxiety and making patients overgo unnecessary additional exams, such as Biopsy.
Invasive tumor tissue is assigned a grade based on how distinct it appears from healthy breast. Breast tumors are graded on three features: the proportion of cancer cells that form tubules, the appearance of the cell nucleus, and how many cells are actively replicating. Each feature is scored on a three-point scale, with a higher score indicating less healthy looking tissue. A grade is assigned based on the sum of the three scores. Combined scores of 3, 4, or 5 represent grade 1, a slower-growing cancer. Scores of 6 or 7 represent grade 2. Scores of 8 or 9 represent grade 3, a faster-growing, more aggressive cancer.
In addition to grading, tumor biopsy samples are tested by immunohistochemistry to determine if the tissue contains the proteins estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER2). Tumors containing either ER or PR are called "hormone receptor-positive" and can be treated with hormone therapies. Around 15 to 20% of tumors contain HER2; these can be treated with HER2-targeted therapies. The remainder that do not contain ER, PR, or HER2 are called "triple-negative" tumors, and tend to grow more quickly than other breast cancer types.
After the tumor is evaluated, the breast cancer case is staged using the American Joint Committee on Cancer and Union for International Cancer Control's TNM staging system. Scores are assigned based on characteristics of the tumor (T), (N), and any metastases (M). T scores are determine by the size and extent of the tumor. Tumors less than 2 (cm) across are designated T1. Tumors 2–5 cm across are T2. A tumor greater than 5 cm across is T3. Tumors that extend to the chest wall or to the skin are designated T4. N scores are based on whether the cancer has spread to nearby lymph nodes. N0 indicates no spread to the lymph nodes. N1 is for tumors that have spread to the closest axillary lymph nodes (called "level I" and "level II" axillary lymph nodes, in the armpit). N2 is for spread to the intramammary lymph nodes (on the other side of the breast, near the chest center), or for axillary lymph nodes that appear attached to each other or to the tissue around them (a sign of more severely affected tissue). N3 designates tumors that have spread to the highest axillary lymph nodes (called "level 3" axillary lymph nodes, above the armpit near the shoulder), to the supraclavicular lymph nodes (along the neck), or to both the axillary and intramammary lymph nodes. The M score is binary: M0 indicates no evidence metastases; M1 indicates metastases have been detected.
TNM scores are then combined with tumor grades and ER/PR/HER2 status to calculate a cancer case's "prognostic stage group". Stage groups range from I (best prognosis) to IV (worst prognosis), with groups I, II, and III further divided into subgroups IA, IB, IIA, IIB, IIIA, IIIB, and IIIC. In general, tumors of higher T and N scores and higher grades are assigned higher stage groups. Tumors that are ER, PR, and HER2 positive are slightly lower stage group than those that are negative. Tumors that have metastasized are stage IV, regardless of the other scored characteristics.
After surgery, many undergo radiotherapy to decrease the chance of cancer recurrence. Those who had lumpectomies receive radiation to the whole breast. Those who had a mastectomy and are at elevated risk of tumor spread – tumor greater than five centimeters wide, or cancerous cells in nearby lymph nodes – receive radiation to the mastectomy scar and chest wall. If cancerous cells have spread to nearby lymph nodes, those lymph nodes will be irradiated as well. Radiation is typically given five days per week, for up to seven weeks. Radiotherapy for breast cancer is typically delivered via external beam radiotherapy, where a device focuses radiation beams onto the targeted parts of the body. Instead, some undergo brachytherapy, where radioactive material is placed into a device inserted at the surgical site the tumor was removed from. Fresh radioactive material is added twice a day for five days, then the device is removed. Surgery plus radiation typically eliminates a person's breast tumor. Less than 5% of those treated have their breast tumor grow back. After surgery and radiation, the breast can be surgically reconstructed, either by adding a breast implant or transferring excess tissue from another part of the body.
Chemotherapy reduces the chance of cancer recurring in the next ten years by around a third. However, 1-2% of those on chemotherapy experience life-threatening or permanent side effects. To balance these benefits and risks, chemotherapy is typically offered to those with a higher risk of cancer recurrence. There is no established risk cutoff for offering chemotherapy; determining who should receive chemotherapy is controversial. Chemotherapy drugs are typically given in two- to three-week cycles, with periods of drug treatment interspersed with rest periods to recover from the therapies' side effects. Four to six cycles are given in total. Many classes of chemotherapeutic agents are effective for breast cancer treatment, including the DNA alkylating drugs (cyclophosphamide), (doxorubicin and epirubicin), (fluorouracil, capecitabine, and methotrexate), (docetaxel and paclitaxel), and platinum-based chemotherapies (cisplatin and carboplatin).
For those whose tumors are HER2-positive, adding the HER2-targeted antibody trastuzumab to chemotherapy reduces the chance of cancer recurrence and death by at least a third. Trastuzumab is given weekly or every three weeks for twelve months. Adding a second HER2-targeted antibody, pertuzumab slightly enhances treatment efficacy. In rare cases, trastuzumab can disrupt heart function, and so it is typically not given in conjunction with anthracyclines, which can also damage the heart.
After their chemotherapy course, those whose tumors are ER-positive or PR-positive benefit from endocrine therapy, which reduces the levels of and that hormone receptor-positive breast cancers require to survive. Tamoxifen treatment blocks the ER in the breast and some other tissues, and reduces the risk of breast cancer death by around 40% over the next ten years. Chemically blocking estrogen production with GnRH-targeted drugs (goserelin, leuprolide, or triptorelin) and aromatase inhibitors (anastrozole, letrozole, or exemestane) slightly improves survival, but has more severe side effects. Side effects of estrogen depletion include , vaginal discomfort, and muscle and joint pain. Endocrine therapy is typically recommended for at least five years after surgery and chemotherapy, and is sometimes continued for 10 years or longer.
Women with breast cancer who had a lumpectomy or a mastectomy and kept their other breast have similar survival rates to those who had a double mastectomy. There seems to be no survival advantage to removing the other breast, with only a 7% chance of cancer occurring in the other breast over 20 years.
Up to 70% of those with ER-positive metastatic breast cancer benefit from additional endocrine therapy. Therapy options include those used in localized cancer, plus toremifene and fulvestrant, often used in combination with CDK inhibitor (palbociclib, ribociclib, or abemaciclib). When one endocrine therapy fails, most will benefit from transitioning to a second one. Some respond to a third sequential therapy as well. Adding an mTOR inhibitor, everolimus, can further slow the tumors' progression.
Those with HER2-positive metastatic disease can benefit from continued use of trastuzumab, alone, in combination with pertuzumab, or in combination with chemotherapy. Those whose tumors continue to progress on trastuzumab benefit from HER2-targeted antibody drug conjugates (HER2 antibodies linked to chemotherapy drugs) trastuzumab emtansine or trastuzumab deruxtecan. The HER2-targeted antibody margetuximab can also prolong survival, as can HER2 inhibitors lapatinib, neratinib, or tucatinib.
Certain therapies are targeted at those whose tumors have particular gene mutations: Alpelisib or capivasertib for those with mutations activating the protein PIK3CA. (olaparib and talazoparib) for those with mutations that inactivate BRCA1 or BRCA2. The immune checkpoint inhibitor antibody atezolizumab for those whose tumors express PD-L1. And the similar immunotherapy pembrolizumab for those whose tumors have mutations in various DNA repair pathways.
In women with non-metastatic breast cancer, psychological interventions such as cognitive behavioral therapy can have positive effects on outcomes such as cognitive impairment, anxiety, depression and mood disturbance, and can also improve the quality of life. Physical activity interventions, yoga and meditation may also have beneficial effects on health related quality of life, cognitive impairment, anxiety, fitness and physical activity in women with breast cancer following adjuvant therapy.
In-person and virtual peer support groups for patients and survivors of breast cancer can promote quality of life and companionship based on similar lived experiences. The potential benefits of peer support are particularly impactful for women with breast cancer facing additional unique challenges related to ethnicity and socioeconomic status. Peer support groups tailored to adolescents and young adult women can improve coping strategies against age-specific types of distress associated with breast cancer, including post-traumatic stress disorder and body image issues.
In addition to the factors that influence cancer staging, a person's age can also impact prognosis. Breast cancer before age 35 is rare, and is more likely to be associated with genetic predisposition to aggressive cancer. Conversely, breast cancer in those aged over 75 is associated with poorer prognosis.
Hormone replacement therapy for treatment of menopause symptoms can also increase a woman's risk of developing breast cancer, though the effect depends on the type and duration of therapy. Combined progesterone/estrogen therapy increases breast cancer risk – approximately doubling one's risk after 6–7 years of treatment (though the same therapy decreases the risk of colorectal cancer). Hormone treatment with estrogen alone has no effect on breast cancer risk, but increases one's risk of developing endometrial cancer, and therefore is only given to women who have undergone hysterectomies.
In the 1980s, the abortion–breast cancer hypothesis posited that induced abortion increased the risk of developing breast cancer. This hypothesis was the subject of extensive scientific inquiry, which concluded that neither nor abortions are associated with a heightened risk for breast cancer.
The use of hormonal birth control does not cause breast cancer for most women; if it has an effect, it is small (on the order of 0.01% per user–year), temporary, and offset by the users' significantly reduced risk of ovarian and endometrial cancers. Among those with a family history of breast cancer, use of modern oral contraceptives does not appear to affect the risk of breast cancer.
Obesity and diabetes increase the risk of breast cancer. A high body mass index (BMI) causes 7% of breast cancers while diabetes is responsible for 2%. At the same time the correlation between obesity and breast cancer is not at all linear. Studies show that those who rapidly gain weight in adulthood are at higher risk than those who have been overweight since childhood. Likewise, excess fat in the midriff seems to induce a higher risk than excess weight carried in the lower body. Dietary factors that may increase risk include a high-fat diet and obesity-related high cholesterol levels.
Dietary iodine deficiency may also play a role in the development of breast cancer.
Smoking tobacco appears to increase the risk of breast cancer, with the greater the amount smoked and the earlier in life that smoking began, the higher the risk. In those who are long-term smokers, the relative risk is increased by 35% to 50%.
A lack of physical activity has been linked to about 10% of cases. Sitting regularly for prolonged periods is associated with higher mortality from breast cancer. The risk is not negated by regular exercise, though it is lowered.
Actions to prevent breast cancer include not drinking alcoholic beverages, maintaining a healthy body composition, avoiding smoking and eating Healthy diet. Combining all of these (leading the healthiest possible lifestyle) would make almost a quarter of breast cancer cases worldwide preventable. The remaining three-quarters of breast cancer cases cannot be prevented through lifestyle changes.
Other risk factors include circadian disruptions related to shift-work and routine late-night eating. A number of chemicals have also been linked, including polychlorinated biphenyls, polycyclic aromatic hydrocarbons, and organic solvents. Although the radiation from mammography is a low dose, it is estimated that yearly screening from 40 to 80 years of age will cause approximately 225 cases of fatal breast cancer per million women screened.
Women with certain genetic variants are at higher risk of developing breast cancer. The most well known are variants of the BRCA mutation BRCA1 and BRCA2. Women with pathogenic variants in either gene have around a 70% chance of developing breast cancer in their lifetime, as well as an approximately 33% chance of developing ovarian cancer. Pathogenic variants in PALB2 – a gene whose product directly interacts with that of BRCA2 – also increase breast cancer risk; a woman with such a variant has around a 50% increased risk of developing breast cancer. Variants in other tumor suppressor genes can also increase one's risk of developing breast cancer, namely p53 (causes Li–Fraumeni syndrome), PTEN (causes Cowden syndrome), and PALB1.
Diabetes mellitus might also increase the risk of breast cancer. Autoimmune diseases such as lupus erythematosus seem also to increase the risk for the acquisition of breast cancer.
Women whose breasts have been exposed to substantial radiation doses before the age of 30 – typically due to repeated chest fluoroscopies or treatment for Hodgkin lymphoma – are at increased risk for developing breast cancer. Radioactive iodine therapy (used to treat thyroid disease) and radiation exposures after age 30 are not associated with breast cancer risk.
Breast cancer, like other , occurs because of an interaction between an environmental (external) factor and a genetically susceptible host. Normal cells divide as many times as needed, and stop. They attach to other cells and stay in place in tissues. Cells become cancerous when they lose their ability to stop dividing, to attach to other cells, to stay where they belong, and to die at the proper time.
Normal cells will self-destruct (apoptosis) when they are no longer needed. Until then, cells are protected from programmed death by several protein clusters and pathways. One of the protective pathways is the PI3K/AKT pathway; another is the RAS/MEK/ERK pathway. Sometimes the genes along these protective pathways are mutated in a way that turns them permanently "on", rendering the cell incapable of self-destructing when it is no longer needed. This is one of the steps that causes cancer in combination with other mutations. Normally, the PTEN protein turns off the PI3K/AKT pathway when the cell is ready for programmed cell death. In some breast cancers, the gene for the PTEN protein is mutated, so the PI3K/AKT pathway is stuck in the "on" position, and the cancer cell does not self-destruct.
Mutations that can lead to breast cancer have been experimentally linked to estrogen exposure. Additionally, G-protein coupled estrogen receptors have been associated with various cancers of the female reproductive system including breast cancer.
Abnormal growth factor signaling in the interaction between and can facilitate malignant cell growth. In breast adipose tissue, overexpression of leptin leads to increased cell proliferation and cancer.
Some mutations associated with cancer, such as p53, BRCA1 and BRCA2, occur in mechanisms to correct errors in DNA. The inherited mutation in BRCA1 or BRCA2 genes can interfere with repair of DNA crosslinks and double-strand breaks (known functions of the encoded protein). These carcinogens cause DNA damage such as DNA crosslinks and double-strand breaks that often require repairs by pathways containing BRCA1 and BRCA2.
GATA-3 directly controls the expression of estrogen receptor (ER) and other genes associated with epithelial differentiation, and the loss of GATA-3 leads to loss of differentiation and poor prognosis due to cancer cell invasion and metastasis.
The American Cancer Society and the American Society of Clinical Oncology advised in 2016 that people should eat a diet high in vegetables, fruits, whole grains, and legumes. Eating foods rich in soluble fiber contributes to reducing breast cancer risk. High intake of citrus fruit has been associated with a 10% reduction in the risk of breast cancer. Marine omega-3 polyunsaturated fatty acids appear to reduce the risk. High consumption of soy-based foods may reduce risk.
Rates of breast cancer vary across the world, but generally correlate with wealth. Around 1 in 12 women are diagnosed with breast cancer in wealthier countries, compared to 1 in 27 in lower income countries. Most of that difference is due to differences in menstrual and reproductive histories – women in wealthier countries tend to menarche earlier and have children later, both factors that increase risk of developing breast cancer. People in lower income countries tend to have less access to breast cancer screening and treatments, and so breast cancer death rates tend to be higher. 1 in 71 women die of breast cancer in wealthy countries, while 1 in 48 die of the disease in lower income countries.
Breast cancer predominantly affects women; less than 1% of those with breast cancer are men. Women can develop breast cancer as early as adolescence, but risk increases with age, and 75% of cases are in women over 50 years old. The risk over a woman's lifetime is approximately 1.5% at age 40, 3% at age 50, and more than 4% risk at age 70.
The oldest discovered evidence of breast cancer is from Egypt and dates back 4200 years, to the Sixth Dynasty. The study of a woman's remains from the necropolis of Qubbet el-Hawa showed the typical destructive damage due to metastatic spread. The Edwin Smith Papyrus describes eight cases of tumors or ulcers of the breast that were treated by cauterization. The writing says about the disease, "There is no treatment." For centuries, physicians described similar cases in their practices, with the same conclusion. Ancient medicine, from the time of the Greeks through the 17th century, was based on humoralism, and thus believed that breast cancer was generally caused by imbalances in the fundamental fluids that controlled the body, especially an excess of black bile. Alternatively it was seen as divine punishment.
Mastectomy for breast cancer was performed at least as early as AD 548, when it was proposed by the court physician Aetios of Amida to Theodora. It was not until doctors achieved greater understanding of the circulatory system in the 17th century that they could link breast cancer's spread to the in the armpit. In the early 18th century the French surgeon Jean Louis Petit performed total mastectomies that included removing the axillary lymph nodes, as he recognized that this reduced recurrence.
When in 1664 Anne of Austria was diagnosed with breast cancer, the initial treatment involved compresses saturated with Conium juice. When the lumps increased the King's physician commenced a treatment with arsenic . The royal patient died in 1666 in atrocious pain. Each failing treatment for breast cancer led to the search for new treatments, spurring a market in remedies that were advertised and sold by quackery, , and apothecaries.
Breast cancer was uncommon until the 19th century, when improvements in sanitation and control of deadly infectious diseases resulted in dramatic increases in lifespan. Previously, most women had died too young to have developed breast cancer. In 1878, an article in Scientific American described historical treatment by pressure intended to induce local ischemia in cases when surgical removal were not possible. William Stewart Halsted started performing radical mastectomies in 1882, helped greatly by advances in general surgical technology, such as aseptic technique and anesthesia. The Halsted radical mastectomy often involved removing both breasts, associated lymph nodes, and the underlying chest muscles. This often led to long-term pain and disability, but was seen as necessary to prevent the cancer from recurring. Before the advent of the Halsted radical mastectomy, 20-year survival rates were only 10%; Halsted's surgery raised that rate to 50%.
Cancer staging were developed in the 1920s and 1930s to determining the extent to which a cancer has developed by growing and spreading. The first study on breast cancer epidemiology was done by Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 controls of the same background and lifestyle for the British Ministry of Health. Radical mastectomies remained the standard of care in the USA until the 1970s, but in Europe, breast-sparing procedures, often followed by radiation therapy, were generally adopted in the 1950s. In 1955 George Crile Jr. published Cancer and Common Sense arguing that cancer patients needed to understand available treatment options. Crile became a close friend of the environmentalist Rachel Carson, who had undergone a Halsted radical mastectomy in 1960 to treat her malign breast cancer.
In the 1980s and 1990s, thousands of women who had successfully completed standard treatment then demanded and received high-dose bone marrow transplants, thinking this would lead to better long-term survival. However, it proved completely ineffective, and 15–20% of women died because of the brutal treatment. The 1995 reports from the Nurses' Health Study and the 2002 conclusions of the Women's Health Initiative trial conclusively proved that HRT significantly increased the incidence of breast cancer.
The breast cancer movement of the 1980s and 1990s developed out of the larger feminist movements and women's health movement of the 20th century. This series of political and educational campaigns, partly inspired by the politically and socially effective AIDS awareness campaigns, resulted in the widespread acceptance of second opinions before surgery, less invasive surgical procedures, support groups, and other advances in care.
Wearing or displaying a pink ribbon has been criticized by the opponents of this practice as a kind of slacktivism, because it has no practical positive effect. It has also been criticized as hypocrisy, because some people wear the pink ribbon to show good will towards women with breast cancer, but then oppose these women's practical goals, like patient rights and anti-pollution legislation. Critics say that the feel-good nature of pink ribbons and pink consumption distracts society from the lack of progress on preventing and curing breast cancer. It is also criticized for reinforcing gender stereotypes and objectifying women and their breasts. Breast Cancer Action launched the "Think Before You Pink" campaign in 2002 against pinkwashing, to target businesses that have co-opted the pink campaign to promote products that cause breast cancer, such as alcoholic beverages.
In 2002 it was noted that as a result of breast cancer's high visibility, the statistical results can be misinterpreted, such as the claim that one in eight women will be diagnosed with breast cancer during their lives – a claim that depends on the unrealistic assumption that no woman will die of any other disease before the age of 95. By 2010 the breast cancer survival rate in Europe was 91% at one years and 65% at five years. In the USA the five-year survival rate for localized breast cancer was 96.8%, while in cases of metastases it was only 20.6%. Because the prognosis for breast cancer was at this stage relatively favorable, compared to the prognosis for other cancers, breast cancer as cause of death among women was 13.9% of all cancer deaths. The second most common cause of death from cancer in women was lung cancer, the most common cancer worldwide for men and women. The improved survival rate made breast cancer the most prevalent cancer in the world. In 2010 an estimated 3.6 million women worldwide have had a breast cancer diagnosis in the past five years, while only 1.4 million male or female survivors from lung cancer were alive.
Breast cancer treatment has improved greatly over the years, but Black women are still less likely to obtain treatment compared to white women. Risk factors such as socioeconomic status, late-stage, or breast cancer at diagnosis, genetic differences in tumor subtypes, and differences in healthcare access all contribute to these disparities. Socioeconomic determinants affecting the disparity in breast cancer illness include poverty, culture, and social injustice. In Hispanic women, the incidence of breast cancer is lower than in non-Hispanic women, but is often diagnosed at a later stage than white women with larger tumors.
Black women are usually diagnosed with breast cancer at a younger age than white women. The median age of diagnosis for Black women is 59, in comparison to 62 in White women. The incidence of breast cancer in Black women has increased by 0.4% per year since 1975 and 1.5% per year among Asian/Pacific Islander women since 1992. Incidence rates were stable for non-Hispanic White, Hispanics, and Native American women. The five-year survival rate is noted to be 81% in Black women and 92% in White women. Chinese and Japanese women have the highest survival rates.
Efforts to promote awareness about the significance of screenings, such as informational materials, are ineffective in reducing these disparities. Successful methods directly address the barriers that prevent access to screenings, such as language barriers or lack of health insurance.
Through community outreach in under-served communities, patient navigators and advocates can offer women personalized assistance with attending screening and follow-up appointments. However, the long-term benefits are unclear, primarily due to a lack of resources and staff to sustain these community-based solutions. Legislation that requires mandatory insurance coverage of language assistance and mammograms has also increased screening rates, particularly among ethnic minority communities. Innovative solutions proven effective include mobile screening vehicles, telehealth consultations, and online tools to assess potential risks and signs of breast cancer.
Within the United States, less than 3% of patients in clinical trials identify as Black, despite representing 12.7% of the national population. Hispanic and indigenous women are also significantly underrepresented in breast cancer research. Lengthy involvement in clinical trials without financial compensation discourages the participation of low-income women unable to miss work or afford traveling expenses. Monetary compensation, language interpreters, and patient navigators can increase the diversity of participants in research and clinical trials.
The latest research is reported annually at scientific meetings such as that of the American Society of Clinical Oncology, San Antonio Breast Cancer Symposium, San Antonio Breast Cancer Symposium Abstracts, newsletters, and other reports of the meeting. and the St. Gallen Oncology Conference in St. Gallen, Switzerland. These studies are reviewed by professional societies and other organizations, and formulated into guidelines for specific treatment groups and risk category.
Fenretinide, a retinoid, is also being studied as a way to reduce the risk of breast cancer. In particular, combinations of ribociclib plus endocrine therapy have been the subject of clinical trials.
A 2019 review found moderate certainty evidence that giving people before breast cancer surgery helped to prevent surgical site infection (SSI). Further study is required to determine the most effective antibiotic protocol and use in women undergoing immediate breast reconstruction.
These AI-driven robots use to provide real-time guidance, analyze imaging data, and execute procedures with precision, ultimately leading to improved surgical outcomes for people with breast cancer. Moreover, AI has the potential to transform the methods of monitoring and personalized treatment, using remote monitoring systems to facilitate continuous observation of a person's health status, assist early detection of disease progression, and enable individualized treatment options. The overall impact of these technological advancements enhances quality of care, promoting more interactive and personalized healthcare solutions.
Screening
Diagnosis
Classification
Management
Local tumors
Chemotherapies from different classes are typically given in combination, with particular chemotherapy drugs selected based on the affected person's health and the different chemotherapeutics' side effects. Anthrocyclines and cyclophosphamide cause [[leukemia]] in up to 1% of those treated. Anthrocyclines also cause congestive heart failure in around 1% of people treated. [[Taxane]]s cause peripheral neuropathy, which is permanent in up to 5% of those treated. The same chemotherapy agents can be given before surgery – called neoadjuvant therapy – to shrink tumors, making them easier to safely remove.
Metastatic disease
Supportive care
Prognosis
Risk factors
Hormonal
Lifestyle
Genetics
Medical conditions
Pathophysiology
Prevention
Lifestyle
Preventive surgery
Medications
Epidemiology
History
Society and culture
Pink ribbon
Breast cancer culture
Emphasis
Health disparities in breast cancer
Disparities in breast cancer screenings
Disparities in breast cancer research
Special populations
Men
Pregnant women
Research
Cryoablation
Breast cancer cell lines
Molecular markers
Metabolic markers
Artificial intelligence
Other animals
See also
Works cited
External links
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