BREAST CANCER: GLOBAL BURDEN, RISK FACTORS, ADVANCES IN DIAGNOSIS AND TREATMENT

Аннотация

Breast cancer remains one of the most significant global health challenges affecting women. With over 2.3 million new cases diagnosed in 2020, it continues to pose a considerable burden on healthcare systems, especially in low- and middle-income countries. This review explores the global burden of breast cancer, its risk factors, and recent advancements in diagnostic and therapeutic strategies. Emphasis is placed on the need for early detection and equitable access to advanced treatments to improve survival outcomes worldwide. Keywords: Breast cancer, global burden, risk factors, diagnosis, treatment, public health, molecular imaging, precision medicine Introduction. Breast cancer has long been recognized as one of the most prevalent and deadly cancers affecting women worldwide. It continues to be a major public health concern, with significant implications for patients, healthcare systems, and societies at large. Over the past decades, considerable progress has been made in understanding its etiology, improving early detection, and advancing therapeutic options. The complexity of the disease, coupled with its varying presentation and progression, has made it a focal point of intensive medical research. Awareness campaigns, international collaborations, and patient advocacy have all contributed to a greater global response, yet challenges remain in achieving equitable care across different regions. Breast cancer remains the most commonly diagnosed cancer among women globally. According to the World Health Organization, more than 2.3 million new cases were reported in 2020 alone. It accounts for approximately 11.7% of all cancer cases and ranks as the fifth leading cause of cancer-related deaths https://scientific-jl.com/luch/ 1 6 9 Часть-46_ Том-5_ июнь-2025 worldwide. Disparities in incidence and mortality rates have been observed across regions, with higher survival rates in high-income countries due to earlier detection and better access to treatment. In contrast, many low- and middle-income countries continue to experience higher mortality rates, often due to late-stage diagnosis and limited healthcare infrastructure. Additionally, urbanization and lifestyle transitions in developing countries have contributed to an increasing incidence rate. As life expectancy improves and more women reach the age of risk, the burden is expected to rise. The psychological, social, and economic consequences of breast cancer extend beyond the individual, affecting families and communities as well. A range of risk factors has been identified in the development of breast cancer. These include non-modifiable factors such as age, gender, genetic mutations (notably BRCA1 and BRCA2), and family history. Hormonal factors, such as early menarche, late menopause, and hormone replacement therapy, have also been associated with increased risk. In addition, modifiable lifestyle factors such as obesity, physical inactivity, alcohol consumption, and exposure to ionizing radiation have been shown to contribute to the risk of developing breast cancer. Recent studies have also indicated the potential role of environmental exposures, dietary patterns, and socioeconomic status in influencing breast cancer risk. The interplay between genetic predisposition and lifestyle factors has gained interest, particularly in developing personalized prevention strategies. Moreover, reproductive history and breastfeeding practices have been identified as protective or risk-enhancing depending on various socio-biological contexts. Significant advances have been made in breast cancer diagnosis. Mammography has remained the cornerstone of early detection, with digital mammography offering improved accuracy. Ultrasound and magnetic resonance imaging (MRI) have been used as supplementary tools, particularly in high-risk populations. More recently, molecular imaging and genomic testing have emerged, https://scientific-jl.com/luch/ 1 7 0 Часть-46_ Том-5_ июнь-2025 enabling more personalized risk assessment and early detection strategies. Liquid biopsy technologies are currently being explored to detect circulating tumor DNA, offering a minimally invasive diagnostic alternative. In addition to imaging and molecular techniques, artificial intelligence (AI) has begun to play a transformative role in diagnostic accuracy. AI-based tools have demonstrated potential in interpreting mammograms with high precision, reducing false positives and negatives. Diagnostic protocols are increasingly integrating risk stratification models, allowing for tailored screening intervals and methods based on individual profiles. Treatment of breast cancer has seen substantial improvements over the years. Surgery, including lumpectomy and mastectomy, remains a primary modality, often combined with radiation therapy. Systemic therapies have evolved to include hormonal therapy, chemotherapy, and targeted therapies such as HER2 inhibitors and CDK4/6 inhibitors. Immunotherapy is also being