Breast Cancer: The Present

Present Treatments:

The female gender is the strongest breast cancer risk factor. Approximately 99% of breast cancers occur in women while 0.5–1% of breast cancers occur in men. There are certain factors that increase the risk of breast cancer, including increasing age, obesity, harmful use of alcohol, family history of breast cancer, history of radiation exposure, reproductive history (such as age that menstrual periods began and age at first pregnancy), tobacco use and postmenopausal hormone therapy. Family history of breast cancer increases the risk of breast cancer as well, but most women diagnosed with breast cancer do not have a known family history of the disease.

As doctors continue to learn more about the disease, breast cancer treatment is becoming more personalized to suit every patients’ specific needs; for example, doctors are able to determine which patients with early stage breast cancer can be treated with hormone therapy alone and who would need the addition of chemotherapy.

Less invasive and toxic techniques:

• Sentinel lymph node biopsy method: the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present and is used in people who have already been diagnosed with cancer

  • SNLB helps doctors determine what stage the cancer has reached and how likely it is for it to spread to other parts of the body. About 20% to 30% of “node-negative” (meaning that the cancer has not spread to the lymph nodes) patients have cancer in their lymph nodes even though imaging studies like CT scans and ultrasounds suggest that the lymph nodes are negative or do not contain disease.

• Short courses of radiation: whole breast irradiation delivered once per day over a 3-5 week span reduces it from happening again and gives good cosmetic results

• Targeted therapy: medicines that are directed at target proteins on breast cancer cells that help them grow, spread, and live longer

  • Most common targeted therapy medicines for breast cancer target the protein HER2

    • This protein helps the cancer cells grow and survive

    • Targeted therapy medicine attacks the cells that are making extra HER2 and doesn't hurt healthy cells

• Gene therapy: sends genetic material into target cells to edit the gene and change the expression of a gene’s product, and achieving the goal of treating cancers

• Strategies include:

  • Gene editing

  • Targeting transcription factors, microRNA, and breast cancer cells

  • DNA/RNA vaccination

• Brachytherapy/Internal Radiation: a way to deliver accelerated partial-breast radiation that involves placing radioactive material inside the body

  • Accelerated partial-breast radiation gives a larger dose of radiation over a shorter period of time to only the part of the breast where the cancer is, rather than the entire breast

  • Although it may be beneficial in most cases, certain issues may arise with size and location of the cancer that may limit who is a potential brachytherapy candidate

  • Most commonly delivered using a number of small tubes or catheters or with a balloon-catheter

    
    

Extent of the Issue:

Breast cancer is the second leading cause of cancer death in women. (Only lung cancer kills more women each year.) The chance that any woman will die from breast cancer is about 1 in 43 (about 2.3%). It occurs in every country of the world in women at any age after puberty but with increasing rates in later life.

In 2022, there were an estimated 2.3 million women diagnosed with breast cancer and 670, 000 deaths globally.

Global estimates reveal striking inequities in the breast cancer burden according to human development. For instance, in countries with a very high Human Development Index (HDI), 1 in 12 women will be diagnosed with breast cancer in their lifetime and 1 in 71 women die of it.

In contrast, in countries with a low HDI, only 1 in 27 women is diagnosed with breast cancer in their lifetime, while 1 in 48 women will die from it.

In recent years, incidence rates have increased by 1% per year. The rise in incidence rates is a little steeper in women younger than 50. This is thought to be due to risk factors of having excess body weight, not having children, or having a first child after age 30.

Some variations in breast cancer can be seen in racial and ethnic groups. For example:

• Black women have the highest death rate from breast cancer

• At every age, Black women are more likely to die from breast cancer than any other race or ethnic group

• White, Asian, and Pacific Islander women are more likely to be diagnosed with localized breast cancer than Black, Hispanic, American Indian, and Alaska Native women.

• Asian and Pacific Islander women have the lowest death rate from breast cancer.

References:

American Cancer Society. (2023). Breast cancer treatment | treatment options for breast cancer. Www.cancer.org. https://www.cancer.org/cancer/types/breast-cancer/treatment.html

Blackburn, K. B. (2019). Sentinel lymph node biopsy: What cancer patients should know. MD Anderson Cancer Center.

https://www.mdanderson.org/cancerwise/sentinel-lymph-node-biopsy--what-cancer-patients-should-know.h00-159299889.html

DePolo , J. (n.d.). Brachytherapy or internal radiation. Www.breastcancer.org. https://www.breastcancer.org/treatment/radiation-therapy/internal

Hirko, K. A., Rocque, G., Reasor, E., Taye, A., Daly, A., Cutress, R. I., Copson, E. R., Lee, D.-W., Lee, K.-H., Im, S.-A., & Park, Y. H. (2022). The impact of race and ethnicity in breast cancer—disparities and implications for precision oncology. BMC Medicine, 20(1). https://doi.org/10.1186/s12916-022-02260-0

Mayo Clinic. (2025, January 10). Breast cancer - diagnosis and treatment - mayo clinic. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475

National Cancer Institute. (2019, June 25). Sentinel lymph node biopsy. National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet

Wang, J., & Wu, S.-G. (2023). Breast cancer: An overview of current therapeutic strategies, challenge, and perspectives. Breast Cancer: Targets and Therapy, 15(15), 721–730. https://doi.org/10.2147/bctt.s432526

Whelan, T. J., Julian, J. A., Berrang, T. S., Kim, D.-H., Germain, I., Nichol, A. M., Akra, M., Lavertu, S., Germain, F., Fyles, A., Trotter, T., Perera, F. E., Balkwill, S., Chafe, S., McGowan, T., Muanza, T., Beckham, W. A., Chua, B. H., Gu, C. S., & Levine, M. N. (2019). External beam accelerated partial breast irradiation versus whole breast irradiation after breast conserving surgery in women with ductal carcinoma in situ and node-negative breast cancer (RAPID): a randomised controlled trial. The Lancet, 394(10215), 2165–2172. https://doi.org/10.1016/s0140-6736(19)32515-2

WHO. (2025, August 14). Breast cancer. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/breast-cancer