2023: Everything You Need to Know

Breast Cancer Awareness Month is an annual campaign that takes place every October to increase awareness, education, and support for breast cancer prevention, detection, treatment, and care. It is a global initiative that involves various organizations, institutions, communities, and individuals who are committed to fighting against breast cancer. In this article, we will cover everything you need to know about breast cancer awareness month 2023: from facts and figures to events and entertainment. We will also provide some tips and resources on how you can get involved and make a difference.

Breast Cancer Facts and Figures

Breast cancer is the most common cancer among women worldwide. According to the International Agency for Research on Cancer (IARC), there were an estimated 2.3 million new cases of breast cancer in 2020, accounting for 24% of all new cancer cases among women. Breast cancer was also the second most common cause of cancer death among women in 2020, with an estimated 685 thousand deaths, accounting for 15% of all cancer deaths among women.

Breast cancer can also affect men, although less frequently than women. According to IARC, there were an estimated 21 thousand new cases of male breast cancer in 2020, accounting for 0.2% of all new cancer cases among men. Male breast cancer was also the 18th most common cause of cancer death among men in 2020, with an estimated 6 thousand deaths, accounting for 0.1% of all cancer deaths among men.

The incidence and mortality rates of breast cancer vary widely across regions and countries. Some of the factors that influence these rates include genetic, environmental, lifestyle, reproductive, hormonal, and healthcare factors. For example, breast cancer incidence rates are higher in developed regions than in developing regions, while breast cancer mortality rates are higher in developing regions than in developed regions. This reflects the differences in risk factors exposure, screening practices, diagnosis accuracy, treatment availability, and survival outcomes among different populations.

The following table shows the estimated number and percentage of new cases and deaths of breast cancer by region in 2020:

Region	New Cases	Percentage of New Cases	Deaths	Percentage of Deaths
Africa	168,694	7.3%	76,571	11.2%
Americas	494,477	21.4%	116,843	17.1%
Asia	1,161,853	50.3%	384,583	56.1%
Europe	523,467	22.7%	104,973	15.3%
Oceania	19,930	0.9%	5,688	0.8%
World	2,368,421	100%	688,658	100%

 

The following table shows the estimated age-standardized incidence and mortality rates (per 100,000 population) of breast cancer by region in 2020:

Region	Incidence Rate	Mortality Rate
Africa	30.8	15.5
Americas	71.9	14.6
Asia	39.3	12.8
Europe	94.8	18.8
Oceania	94.5	13.9
World	55	13

 

Breast cancer can be prevented by avoiding or reducing exposure to known risk factors. Some of the risk factors that are modifiable include smoking, alcohol consumption, obesity, physical inactivity, hormone therapy, oral contraceptives, etc. Some of the risk factors that are non-modifiable include age, gender, family history, genetic mutations, etc. The World Health Organization (WHO) recommends the following measures to prevent breast cancer:

• Avoid tobacco use
• Limit alcohol intake
• Maintain a healthy weight
• Engage in regular physical activity
• Eat a balanced diet rich in fruits and vegetables
• Breastfeed if possible
• Avoid or limit hormone therapy
• Consult a doctor if you have a family history or genetic predisposition to breast cancer

Breast Cancer Screening and Diagnosis

Breast cancer can be detected early by regular screening. Screening is the process of looking for signs of cancer before symptoms appear or before the cancer becomes too advanced to treat effectively. Early detection can improve the chances of survival, reduce the need for aggressive treatment, and enhance the quality of life of people with breast cancer.

The most common method of screening for breast cancer is mammography. Mammography is an X-ray examination of the breasts that can detect changes or abnormalities that may indicate cancer. Mammography can detect breast cancer up to two years before it can be felt by a physical examination. However, mammography is not perfect and has some limitations. For example, mammography may miss some cancers that are too small or hidden by dense breast tissue. Mammography may also produce false-positive results that lead to unnecessary tests or procedures.

Other methods of screening for breast cancer include clinical breast examination (CBE) and breast self-examination (BSE). CBE is a physical examination of the breasts by a healthcare provider that can detect lumps or other changes that may indicate cancer. BSE is a personal examination of the breasts by oneself that can help one become familiar with the normal look and feel of the breasts and notice any changes that may indicate cancer. However, CBE and BSE are not as effective as mammography in detecting breast cancer and are not recommended as substitutes for mammography.

The American Cancer Society (ACS) recommends the following guidelines for breast cancer screening for women at average risk:

• Women aged 40 to 44 should have the choice to start annual mammograms if they wish to do so.
• Women aged 45 to 54 should get mammograms every year.
• Women aged 55 and older should switch to mammograms every two years or continue yearly screening.
• Women should continue screening as long as they are in good health and expected to live at least 10 more years.
• Women should also be familiar with the normal look and feel of their breasts and report any changes to their health care provider.

The ACS also recommends the following guidelines for breast cancer screening for women at higher than 2of5 average risk:

• Women who have a personal history of breast cancer, a family history of breast cancer in a first-degree relative (mother, sister, daughter), or a genetic mutation that increases the risk of breast cancer (such as BRCA1 or BRCA2) should talk to their health care provider about starting mammograms earlier, having additional tests (such as MRI), or having more frequent exams.
• Women who have a lifetime risk of breast cancer of 20% or more, according to risk assessment tools based on family history and other factors, should get an MRI and a mammogram every year, starting at age 30.
• Women who have had radiation therapy to the chest between the ages of 10 and 30 should get an MRI and a mammogram every year, starting at age 25 or 10 years after the radiation, whichever is later.

The ACS also recommends the following guidelines for breast cancer screening for men at higher-than-average risk:

• Men who have a genetic mutation that increases the risk of breast cancer (such as BRCA1 or BRCA2) or a strong family history of breast cancer should talk to their health care provider about the benefits and limitations of breast exams and mammograms.
• Men who have had radiation therapy to the chest between the ages of 10 and 30 should talk to their health care provider about the benefits and limitations of breast exams and mammograms.

The ACS emphasizes that these are general guidelines and that each person’s situation is different. Therefore, it is important to consult with a healthcare provider about the best screening plan for one’s individual risk and preferences.

If screening tests find something abnormal, further tests are needed to confirm or rule out the presence of cancer. These tests may include:

• Diagnostic mammography: A more detailed X-ray examination of the breasts that can provide more information about the size, shape, and location of any abnormalities.
• Ultrasound: A test that uses sound waves to create images of the breasts that can help distinguish between solid masses (such as tumors) and fluid-filled cysts.
• Biopsy: A procedure that involves removing a small sample of tissue from the suspicious area and examining it under a microscope for signs of cancer. There are different types of biopsies, such as fine needle aspiration, core needle biopsy, stereotactic biopsy, etc. The type of biopsy depends on the size, location, and characteristics of the abnormality.
• Magnetic resonance imaging (MRI): A test that uses a powerful magnet and radio waves to create detailed images of the breasts that can help detect cancers that are not visible on mammograms or ultrasounds. MRI is usually reserved for women who have a high risk of breast cancer or who have dense breasts which makes mammography less effective.

The diagnosis of breast cancer is based on the results of these tests, as well as the clinical examination and medical history of the patient. The diagnosis also includes information about the type, stage, and characteristics of the cancer, such as:

• The type of breast cancer: There are different types of breast cancer that originate from different cells in the breast. The most common types are invasive ductal carcinoma (IDC), which starts in the milk ducts and spreads to other parts of the breast; invasive lobular carcinoma (ILC), which starts in the milk-producing lobules and spreads to other parts of the breast; ductal carcinoma in situ (DCIS), which is non-invasive cancer that stays within the milk ducts; lobular carcinoma in situ (LCIS), which is a non-invasive condition that increases the risk of developing invasive breast cancer; and inflammatory breast cancer (IBC), which is a rare but aggressive type of breast cancer that causes redness, swelling, and warmth in the breast.
• The stage of breast cancer: The stage of breast cancer describes how far the cancer has spread within the breast or to other parts of the body. The stage is determined by factors such as the size of the tumor, the number, and location of lymph nodes involved, and whether there are distant metastases. The stage is usually expressed by a number from 0 to IV, with higher numbers indicating more advanced disease. For example, stage 0 means no evidence of invasive cancer; stage I means a small tumor confined to the breast; stage II means a larger tumor or spread to nearby lymph nodes; stage III means extensive spread to nearby tissues or lymph nodes; and stage IV means distant spread to organs such as bones, lungs, liver, etc.

The characteristics of breast cancer: The characteristics of breast cancer describe some features of the cancer cells that can help determine the prognosis and treatment options. Some common characteristics are hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, and tumor grade. Hormone receptor status indicates whether the cancer cells have receptors for the hormones estrogen and progesterone, which can stimulate their growth. Hormone receptor status can be positive (meaning the cancer cells have receptors) or negative (meaning the cancer cells do not have receptors). Hormone receptor-positive breast cancers can be treated with hormone therapy, which blocks or lowers the amount of hormones in the body. Hormone receptor-negative breast cancers do not respond to hormone therapy and need other types of treatment. HER2 status indicates whether the cancer cells have too many copies of a gene called HER2, which makes a protein that helps them grow and spread. HER2 status can be positive (meaning the cancer cells have too many copies of the gene) or negative (meaning the cancer cells have normal or low levels of the gene). HER2-positive breast cancers can be treated with targeted therapy, which blocks the action of the HER2 protein. HER2-negative breast cancers do not respond to targeted therapy and need other types of treatment. Tumor grade indicates how abnormal the cancer cells look under a microscope and how quickly they are likely to grow and spread. Tumor grade can be low (meaning the cancer cells look more like normal cells and are less aggressive), intermediate (meaning the cancer cells look somewhat abnormal and have a moderate level of aggressiveness), or high (meaning the cancer cells look very different from normal cells and are very aggressive).

Breast Cancer Treatment and Care

Breast cancer treatment and care depend on the type, stage, and characteristics of the cancer, as well as the patient’s preferences and overall health. The main goals of treatment are to remove or destroy the cancer, prevent it from coming back or spreading, and relieve any symptoms or complications. The main types of treatment are:

• Surgery: A procedure that involves removing part or all of the breast, as well as some nearby tissues or lymph nodes that may contain cancer cells. Surgery can be either breast-conserving (such as lumpectomy or partial mastectomy) or breast-removing (such as mastectomy). Surgery can also be combined with reconstruction, which is a procedure that restores the shape and appearance of the breast after surgery. Surgery is usually the first step of treatment for most early-stage breast cancers.
• Chemotherapy: A treatment that uses drugs to kill or stop the growth of cancer cells. Chemotherapy can be given before surgery (called neoadjuvant chemotherapy) to shrink the tumor and make it easier to remove, after surgery (called adjuvant chemotherapy) to lower the risk of recurrence or metastasis, or as the main treatment for advanced or metastatic breast cancers. Chemotherapy can be given intravenously (through a vein) or orally (by mouth). Chemotherapy can cause side effects such as hair loss, nausea, vomiting, fatigue, infection, etc.
• Radiation therapy: A treatment that uses high-energy rays or particles to damage or destroy cancer cells. Radiation therapy can be given after surgery (called adjuvant radiation therapy) to kill any remaining cancer cells in the breast or nearby areas, before surgery (called neoadjuvant radiation therapy) to shrink the tumor and make it easier to remove, or as the main treatment for advanced or metastatic breast cancers. Radiation therapy can be given externally (from a machine outside the body) or internally (from a radioactive source inside the body). Radiation therapy can cause side effects such as skin changes, fatigue, swelling, etc.
• Hormone therapy: A treatment that blocks or lowers the amount of hormones in the body that can stimulate the growth of hormone receptor-positive breast cancers. Hormone therapy can be given after surgery (called adjuvant hormone therapy) to lower the risk of recurrence or metastasis, before surgery (called neoadjuvant hormone therapy) to shrink the tumor and make it easier to remove, or as the main treatment for advanced or metastatic breast cancers. Hormone therapy can be given orally (by mouth), by injection (into a muscle), by implant (under the skin), or by surgery (removing the ovaries). Hormone therapy can cause side effects such as hot flashes, vaginal dryness, mood changes, bone loss, etc.

Targeted therapy: A treatment that targets specific molecules or pathways that are involved in the growth and spread of cancer cells. Targeted therapy can be given after surgery (called adjuvant targeted therapy) to lower the risk of recurrence or metastasis, before surgery (called neoadjuvant targeted therapy) to shrink the tumor and make it easier to remove, or as the main treatment for advanced or metastatic breast cancers. Targeted therapy can be given intravenously (through a vein) or orally (by mouth). Targeted therapy can cause side effects such as skin rash, diarrhea, heart problems, etc.

• Immunotherapy: A treatment that stimulates or enhances the immune system’s ability to fight cancer cells. Immunotherapy can be given after surgery (called adjuvant immunotherapy) to lower the risk of recurrence or metastasis, before surgery (called neoadjuvant immunotherapy) to shrink the tumor and make it easier to remove, or as the main treatment for advanced or metastatic breast cancers. Immunotherapy can be given intravenously (through a vein) or by injection (under the skin). Immunotherapy can cause side effects such as fever, chills, fatigue, infection, etc.

The choice of treatment depends on several factors, such as:

• The type, stage, and characteristics of the cancer
• The patient’s age, menopausal status, general health, and personal preferences
• The benefits and risks of each treatment option
• The availability and accessibility of each treatment option

The treatment plan may also change over time, depending on the response and tolerance of the patient. The treatment plan may involve one or more types of treatment, given alone or in combination, in a specific order or sequence. The treatment plan may also include supportive care, which is a type of care that helps improve the quality of life of patients and their families by addressing physical, emotional, social, and spiritual needs. Supportive care may include pain management, palliative care, nutrition counseling, psychological counseling, social work, spiritual care, etc.

Breast cancer treatment and care require a multidisciplinary team of health care professionals who work together to provide the best possible care for each patient. The team may include:

• Surgeons: Doctors who perform operations to remove or reconstruct the breast and nearby tissues
• Medical oncologists: Doctors who specialize in treating cancer with drugs such as chemotherapy, hormone therapy, targeted therapy, immunotherapy, etc.
• Radiation oncologists: Doctors who specialize in treating cancer with radiation therapy
• Pathologists: Doctors who examine tissue samples under a microscope to diagnose and classify cancer
• Radiologists: Doctors who use imaging tests such as mammography, ultrasound, MRI, etc. to diagnose and monitor cancer
• Oncology nurses: Nurses who provide care and education to patients during and after treatment
• Oncology pharmacists: Pharmacists who prepare and dispense drugs for cancer treatment and manage drug-related issues
• Oncology social workers: Social workers who provide emotional support and practical assistance to patients and their families
• Oncology psychologists: Psychologists who help patients cope with the psychological impact of cancer and its treatment
• Oncology dietitians: Dietitians who provide nutrition advice and guidance to patients during and after treatment
• Oncology physical therapists: Physical therapists who help patients regain physical function and mobility after treatment
• Oncology occupational therapists: Occupational therapists who help patients resume daily activities and work after treatment
• Oncology speech therapists: Speech therapists who help patients with speech and swallowing problems after treatment
• Oncology genetic counselors: Genetic counselors who provide information and testing for patients with a family history or genetic predisposition to breast cancer

Breast cancer treatment and care can be challenging and stressful for patients and their families. Therefore, it is important to seek support from various sources, such as:

• Family and friends: They can provide emotional support, practical help, companionship, and encouragement.
• Support groups: They can offer a safe space to share experiences, feelings, questions, and tips with other people who are going through similar situations.
• Online communities: They can provide information, advice, resources, and connections with people from different locations who have similar interests or concerns.
• Organizations and agencies: They can offer services, programs, financial assistance, legal advice, advocacy, and referrals for patients and their families.

Conclusion

Breast cancer is a complex and heterogeneous disease that affects millions of people worldwide. It requires a personalized and holistic approach to treatment and care, involving a multidisciplinary team of health care professionals and various sources of support. Patients and their families should be well-informed and actively involved in the decision-making process, as well as the management of side effects and long-term outcomes. Breast cancer treatment and care can be a challenging and stressful journey, but with the right information, guidance, and support, it can also be a rewarding and empowering one.