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Leggat-Barr K, Yee D, Duralde E, Hodge C, Borges V, Baxter M, Valdez J, Morgan T, Garber J, Esserman L. A roadmap to reduce the incidence and mortality of breast cancer by rethinking our approach to women's health. Breast Cancer Res Treat 2025; 209:1-14. [PMID: 39531132 PMCID: PMC11785669 DOI: 10.1007/s10549-024-07522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 10/10/2024] [Indexed: 11/16/2024]
Abstract
Despite progress, breast cancer remains the most feared disease among women. In the USA alone, the incidence is now almost 300,000 new cancers per year, a rate that has nearly doubled in the last 30 years. Most women survive, but over 40,000 women a year still die of their disease [99]. It is the most diagnosed cancer among women and the second leading cause of cancer death. Important disparities exist in breast cancer outcomes among African American women, where women die of breast cancer at higher rates, are diagnosed younger, and at a more advanced stage. We are proposing a radical shift in our thinking about breast cancer prevention with an aspiration to dramatically lower breast cancer incidence. Most breast cancers are driven by steroid hormones. Throughout the life course, women are offered an array of hormonal treatments for menstrual cycle control, family planning, in vitro fertilization, postpartum weaning, and menopausal symptom management. There are mixed data on the extent to which each of these may contribute to increased or decreased risk for breast cancer. These endocrine manipulations could represent a great opportunity to potentially reduce breast cancer incidence and improve quality of life for survivors. To date, they have not been designed to explicitly reduce breast cancer risk. A new holistic approach will require scientists, drug developers, breast oncologists, obstetricians, gynecologists, endocrinologists, radiologists, and family medicine/internists to work together toward the common goal of reducing breast cancer risk while addressing other critical issues in women's health.
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Affiliation(s)
| | - Douglas Yee
- Masonic Cancer Center Minneapolis, University of Minnesota, Minneapolis, MN, USA
| | | | - Caroline Hodge
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Virginia Borges
- Division of Medical Oncology, University of Colorado Cancer Center, Aurora, CO, USA
| | - Molly Baxter
- Johns Hopkins Medical School, Baltimore, MD, USA
| | - Jessica Valdez
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Tamandra Morgan
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Judy Garber
- Dana Farber Cancer Institute, Boston, MA, USA
| | - Laura Esserman
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
- Alfred A de Lorimier Endowed Chair in General Surgery, 1825 4th St, 3rd Floor, San Francisco, CA, 94158, USA.
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