Breast cancer

Breast cancer is the most frequent type of cancer and the most common cause of cancer death affecting women globally. Breast cancer causes more disability-adjusted life-years lost by women than any other cancer. The burden posed by breast cancer is disproportionally larger in developing countries, where most breast cancer deaths occur prematurely, in women younger than 70 years.

The Americas accounted for nearly a quarter of new breast cancer cases in 2020. In Latin America and the Caribbean, the share of women affected by the disease before the age of 50 years (32%) is much larger than in North America (19%).

The outlook after a breast cancer diagnosis has improved dramatically in high income countries countries, which have experienced a 40% decrease in age-standardized breast cancer mortality between 1980 and 2020, following the introduction of early detection programs and standardized treatment protocols. Effective early detection and access to effective treatment remain a challenge for countries with limited resources, despite there being proven and cost-effective interventions. Substantial improvements in global cancer control can be achieved by implementing what we already know works.

Key facts

Breast cancer is the most common cancer and the most common cause of cancer death in women in the Americas.
In 2020, there were more than 210,000 new diagnoses of breast cancer in Latin America and the Caribbean, and nearly 68,000 deaths.
Characteristics that are associated with higher risk of developing breast cancer include obesity, alcohol consumption, family history of breast cancer, exposure to radiation, reproductive and hormonal history and tobacco use. Around half of cases develop in women with no identified risk factors other than female gender and age 40 years and older.
Breast cancer arises in the lining cells of the ducts (85%) or lobules (15%) in glandular tissue of the breast.
When confined to the duct or lobule where it started, it causes no symptoms, but may progress and invade the surrounding tissue, and eventually local lymph nodes and other organs.
The burden of breast cancer can be reduced by identifying and treating cancers early, before they give any symptoms. In well-resourced settings, organized screening with mammography is recommended every two years for women aged 50-69 years. In limited-resource settings, where mammography screening programs may not be feasible, clinical breast examination seems to be the way forward (see
Breast cancer most commonly presents as a painless lump in the breast. It is important that women finding an abnormal lump consult a health practitioner as soon as possible even if there is no pain.
Breast lumps may develop for reasons other than cancer (up to 90%). Breast cancer may present in a many ways, which is why a complete medical examination is important. Other symptoms of breast cancer include breast thickening, alteration in size, shape or appearance of the breast, alterations of the skin such as redness, pitting or dimpling, change in nipple appearance or the skin around (areola), and or abnormal nipple discharge. Advanced breast cancers can erode through the skin and spread to other body parts, triggering additional symptom.
Breast cancer treatment can be effective, particularly when caught early. It usually entails surgery with or without radiation and medication. The effectiveness of treatment depends on undergoing the full course of treatment.
Palliative and supportive care help improve the quality of life of patients and their families and may also positively influence the course of illness, aiming to meet the supportive care, psychosocial and spiritual needs of women with breast cancer.

PAHO Response

The WHO Global Breast Cancer Initiative aims to reduce global cancer mortality by 2.5% per year, thus avoiding 2.5 million early deaths due to breast cancer between 2020 and 2040 in women under the age of 70 years. The Global Breast Cancer Initiative roots from long-standing commitment from breast cancer advocates worldwide, and is now engaging global partners to coordinate efforts to advance breast cancer control.

Data/Statistics

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Cancer disease burden visualization

PAHO: Noncommunicable Diseases and Mental Health

Strategic Partners

PAHO/WHO Collaborating Centres

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Breast cancer is the most common cancer and the most common cause of cancer death in women in the Americas.

The pillars for achieving this mortality reduction are:

Health promotion for early detection: public health education to improve awareness of the signs and symptoms, and of the importance of early detection and treatment.
Timely diagnosis: public and health worker education on signs and symptoms of early breast cancer so women are referred to diagnostic services when appropriate
Comprehensive breast cancer management: because cancer management requires some level of specialized care, establishing centralized services, treatment for breast cancer can be optimized.

The efforts of the Initiative focus on multisectoral partnerships, promoting sustainable capacity building, innovation and the use of data for monitoring and decision-making, and will be operationalized through the following interrelated approaches:

Convening stakeholders and developing a platform for action: bringing global partners together in working groups to address the pillars mentioned above.
Operational guidance: developing technical package to guide the implementation of the Global Breast Cancer Initiative through shared learning platforms and following a four-step scheme: Assess, Plan, Implement, and Monitor.
In-country engagement and support: Harnessing political will to generate action at global and local level through strengthening of partnerships and integrating existing cancer initiatives.

KEY ACTIONS BY PAHO

PAHO, as the Regional Office for the Americas of the World Health Organization, has been part of the two Global Breast Cancer Consultations that have taken place in 2021 bringing together multisectoral stakeholders and global experts in different technical working groups to accelerate the implementation of the Global Breast Cancer Initiative. PAHO/WHO is committed to advance the Global Breast Cancer Initiative, by promoting a comprehensive approach to breast cancer prevention and control through health education, early detection, diagnosis, treatment and palliative care working with its Member States in the following actions:

Advocacy and communication to raise the priority of breast cancer on the public health agenda, as well as to improve awareness and understanding of the burden of this disease among women, their families, and communities.

Technical assistance to improve the quality and access to mammography services, and training of mammography personnel.

Promotion of evidence-based guidelines,, stratified according to available resources, for screening, diagnosis, and treatment.

Improving quality and access to radiotherapy services and strengthening capacity for cancer treatment in the region.

Integrating breast health awareness within primary care services.

Breast Cancer: Knowledge summaries for health professionals

Breast cancer is among the most common cancer in women in the Americas, where more than 462,000 women were diagnosed and aproximately 100,000 women died from breast cancer every year.

Access the sumaries