Breast cancer in global health: beyond diversity and inequality

Abstract

Over the past 50 years, we have seen several innovations and breakthroughs in breast cancer screening, molecular diagnosis, prevention, and adjuvant treatment, which have led to a substantial reduction in mortality. However, upon looking at its prevalence on a global scale, this achievement seems to be limited to western and some developed countries. The mortality of breast cancer is stable or even increasing in most other countries, and is a major threat to women’s global health. According to the worldwide epidemiological data and recent advances in genetics, we have begun to understand that there may be geographic, racial, ethnic, and possibly cultural diversity in terms of genetic predisposition, age-standardized incidence, and mortality of breast cancer. A deeper understanding of this potential diversity is essential to establish screening and prevention schemes as well as systematic treatments that are optimized for the epidemiological and genetic characteristics of each region. Considering most of the key evidence regarding breast cancer has been generated mainly in western countries, multidisciplinary global communication will facilitate understanding of breast cancer diversity, promote the equality and individualization of breast management, and improve breast cancer survival worldwide.