Breast cancer is the most frequently diagnosed malignancy among women worldwide. In 2022, an estimated 2.3 million women were newly diagnosed with breast cancer, and approximately 670,000 deaths were attributed to the disease. In high-income countries, the five-year survival rate exceeds 90%, whereas it is around 66% in India and only 40% in South Africa. This pronounced disparity reflects inequitable access to healthcare services as well as cultural, social, and economic challenges that vary across regions. Yet, breast cancer prevention is both feasible and achievable through adequate health education and the implementation of effective screening programs. According to the World Health Organization (WHO), if current trends persist, the incidence and mortality rates of breast cancer are projected to increase by 40% by the year 2050.
Breast cancer is a disease characterized by the uncontrolled proliferation of abnormal cells within the mammary gland, leading to the formation of a tumor with the potential to spread throughout the body. Malignant breast cells typically begin to multiply within the milk-producing ducts and/or lobules. The early, non-invasive form (carcinoma in situ) is not life-threatening and can often be detected at an initial stage. However, it is important to note that cancer cells may invade adjacent breast tissue, leading to localized thickening and nodule formation. Invasive breast carcinoma has the ability to spread to nearby lymph nodes and subsequently metastasize to distant organs. Treatment strategies depend on the histological type of the tumor and the extent of disease dissemination. Metastatic breast cancer is considered life-threatening and potentially fatal.
Epidemiology
Statistically, one in every eight diagnosed cancer cases worldwide is breast cancer. According to data from the Global Cancer Observatory (GLOBOCAN, 2025), an estimated 2.45 million new breast cancer cases were identified globally, accounting for 11.5% of all cancer diagnoses across both sexes. Breast cancer also remains a leading cause of cancer-related mortality among women. Based on 2022 data, it was responsible for approximately 6.9% of all cancer deaths worldwide. As of 2025, an estimated 316,950 women were newly diagnosed with invasive breast cancer, while an additional 59,080 cases were identified as ductal carcinoma in situ (DCIS), a non-invasive form of the disease confined to the ductal epithelium.
A global study has demonstrated that the incidence and mortality rates of breast cancer are unevenly distributed across countries. In some nations, the burden is substantially higher, while in others it is comparatively lower. This disparity is closely linked to a country’s level of development, as reflected by its Human Development Index (HDI), which encompasses indicators such as education, income, and life expectancy.
In countries with a very high Human Development Index (HDI), one in every 12 women is diagnosed with breast cancer during her lifetime, while one in every 71 women dies from the disease. In contrast, in countries with a low HDI, although only one in 27 women is diagnosed with breast cancer, one in 48 women dies from it.
In developed countries, the high age-standardized incidence rate (ASIR) of breast cancer is largely attributed to the prevalence of certain risk factors, including advanced age, delayed onset or absence of first pregnancy, limited breastfeeding, late menarche, obesity, the use of hormonal contraceptives, and the widespread administration of postmenopausal hormone replacement therapy. However, despite the increasing incidence, the prognosis in highly developed nations remains favorable due to effective public health programs, broad access to high-quality medical care, and timely diagnosis. As a result, the five-year survival rate following a breast cancer diagnosis exceeds 90%. In contrast, in less developed countries, the overall incidence of breast cancer remains comparatively low, yet mortality rates are disproportionately high—primarily due to delayed detection and limited access to appropriate treatment.
Signs and symptoms of breast cancer
In the early stages of cancer, most patients are asymptomatic, which underscores the critical importance of early diagnosis. Breast cancer can present with a variety of symptoms, the manifestation of which depends largely on the extent of metastasis:
- Painless breast thickening
- Changes in breast size or shape
- Skin dimpling, redness, puckering, or other alterations
- Changes in the appearance of the nipple or the areolar skin surrounding the nipple
- Unusual nipple discharge, which may be bloody
Breast cancer risk factors
Breast cancer predominantly affects females, accounting for approximately 99% of cases, with only 0.5% to 1% occurring in males. Several risk factors are associated with an increased likelihood of developing breast cancer, including age, obesity, alcohol consumption, a family history of breast cancer, prior exposure to radiation, the age at menarche and first pregnancy, tobacco use, and postmenopausal hormone therapy.
Of particular concern are inherited mutations in genes such as BRCA1, BRCA2, and PALB2, which significantly increase the risk of developing breast cancer. Women who carry mutations in these genes are advised to consider risk-reduction strategies, including prophylactic mastectomy and chemoprevention. Statistically, breast cancer also develops in women without identifiable risk factors other than female sex and age over 40. Mortality rates decrease substantially when breast cancer is detected and treated at an early stage, highlighting the critical importance of timely diagnosis and screening programs.
Breast cancer screening guidelines
According to the guidelines published by the U.S. Preventive Services Task Force (USPSTF), women are categorized into average-risk and high-risk groups. Women at average risk begin mammographic screening at age 40 and continue until age 74. High-risk individuals, defined as those with a greater than 20% lifetime risk, known genetic mutations, a history of chest radiation, or other benign breast conditions, are recommended to start screening earlier and include magnetic resonance imaging (MRI) as part of their surveillance protocol.
Breast cancer management: WHO recommendations
Breast cancer treatment depends on the extent of disease spread beyond the mammary gland, whether to the regional lymph nodes (Stage II or III) or to distant organs (Stage IV). To manage breast cancer and reduce the risk of recurrence, clinicians employ the following therapeutic modalities:
- Surgical removal of the breast tumor, which may involve excision of only the tumor tissue (lumpectomy) or the entire breast (mastectomy). Historically, to prevent cancer spread, a complete axillary lymph node dissection was performed; however, current practice favors sentinel lymph node biopsy, a less invasive procedure with fewer complications.
- Radiotherapy to the breast and surrounding tissues to reduce the risk of recurrence, which also decreases the likelihood of requiring a mastectomy.
- Pharmacologic therapies aimed at destroying cancer cells and preventing metastasis, including hormone therapies for tumors expressing estrogen receptors (ER), progesterone receptors (PR), or HER2 positivity. Chemotherapy is utilized when tumors are hormone receptor-negative, and targeted biologic therapies are also available for specific molecular profiles.
Studies have shown that the earlier breast cancer is diagnosed, the sooner treatment can be initiated at an early stage, allowing the patient to complete the full course of therapy, which significantly enhances treatment efficacy.
Statistics of Georgia
Breast cancer represents the most common cancer localization in Georgia. According to GLOBOCAN data from 2025, there were 1,620 new breast cancer cases and 801 deaths reported in the country. Georgia implements both national “Early Disease Detection and Screening” and municipal “Disease Screening” programs, which include targeted breast cancer screening initiatives. According to the National Center for Disease Control and Public Health, breast cancer incidence decreased by 3.8% in 2024 compared to 2015. Additionally, the 5-year survival rate for women diagnosed with breast cancer in 2020 is approximately 72%. Annually, under the “Pink October” campaign, screening drives, informational, educational, and professional meetings are conducted nationwide. However, despite continuous screening efforts, the number of registered cases has declined from 2022 to 2025. This trend naturally raises questions regarding the effectiveness of breast cancer screening programs in Georgia and what measures need to be implemented to improve statistics and increase screening coverage. Professor Mikheil Janjalia, an oncological surgeon and mammologist, addresses this issue on MedScriptum: “The cornerstone of the fight against breast cancer is early diagnosis, which significantly increases the likelihood of successful treatment. The main challenge currently faced in Georgia is the low participation rate among patients. The country primarily employs a passive screening model, relying on patients to initiate screening visits themselves. To enhance patient engagement, it is essential to implement an active screening model, which involves proactively inviting patients through phone calls, SMS notifications, and other methods. Furthermore, integrating molecular and genetic testing into screening programs is a crucial step that will reduce false-positive results and improve diagnostic accuracy. While these advanced diagnostic tests are available in Georgia, they are not yet covered by government funding, representing a significant financial barrier for many patients. It is highly desirable for these methods to be incorporated into government-funded programs, as this would increase the effectiveness of screening, reduce potential mortality, increase the number of screened patients, and ultimately facilitate earlier detection and improved survival rates of breast cancer.”
Global impact, challenge, and WHO response
From the 1980s to 2020, breast cancer mortality in high-income countries has decreased by 40%. Strategies to improve breast cancer outcomes rely fundamentally on strengthening healthcare systems to ensure the availability of already effective treatment modalities. Therefore, public health efforts focus on raising awareness about the signs and symptoms of breast cancer through education and screening programs. These initiatives empower women and their families to recognize the disease early and seek medical care promptly, facilitating diagnosis and treatment before the cancer progresses. Early detection and intervention remain possible even in settings where mammographic screening is not readily accessible.
In 2021, the World Health Organization (WHO) launched the Global Breast Cancer Initiative (GBCI), aiming to reduce breast cancer mortality worldwide by 2.5% annually and to prevent an estimated 2.5 million deaths by 2040. The initiative is founded on three core principles, known as the 60-60-80 targets: promoting early detection (diagnosing 60% of breast cancer cases at Stage I or II), ensuring timely diagnosis (establishing diagnosis within 60 days of initial presentation), and delivering effective treatment (ensuring 80% of patients complete the recommended course of therapy).
Within this framework, developed countries with high Human Development Index (HDI) scores have achieved the WHO’s desired model. Screening programs in nine countries have reported increased detection and prevalence of breast cancer cases among women under 50 years of age. However, this progress has introduced a new challenge: screening younger populations has raised concerns and debates due to fears of overdiagnosis, false-positive results, unnecessary treatments, and psycho-emotional stress among patients. Consequently, the appropriateness of routine screening for women aged 40-45 remains controversial. Despite these concerns, several low- and middle-income countries have adopted early-age screening programs, with Kenya being one notable example.
WHO’s Pink October 2025 Initiative
As part of the “Pink October” campaign, the World Health Organization (WHO) conducts a storytelling initiative that invites members of the community to share photos and videos illustrating how they observe Breast Cancer Awareness Month. Participants also share personal experiences under the hashtag #EveryStoryIsUnique to amplify awareness. On October 8th, the third informal partners’ meeting of the Global Breast Cancer Initiative (GBCI) took place, where key priorities were discussed. Plans are underway to publish a training manual aimed at developing foundational knowledge, skills, and capacities necessary for implementing the GBCI framework. Locally and regionally, various activities are actively being conducted to raise breast cancer awareness, including exhibitions, informational campaigns, webinars, shows, and other events dedicated to this cause.
Breast cancer is one of the most significant global public health challenges, with its resolution dependent on equitable resource allocation, effective screening, timely diagnosis, and appropriate treatment. Despite progress in high-income countries, global disparities remain a major challenge within healthcare systems. Therefore, early detection, raising public awareness, and strengthening healthcare infrastructure remain pivotal factors, potentially saving thousands of lives worldwide.
Source:
WHO Breast Cancer Awareness Month 2025
Global Breast Cancer Initiative
Nature Medicine: Global patterns and trends in breast cancer incidence and mortality across 185 countries- https://doi.org/10.1038/s41591-025-03502-3
The Breast: ELSEVIER Current and future burden of breast cancer in Asia: A GLOBOCAN data analysis for 2022 and 2050
