Breast Cancer

Breast cancer in a global perspective

Breast cancer is the most common cancer in women worldwide, with about 2.3 million new cases and 670,000 deaths each year. While outcomes have improved in many countries, there are still large differences between regions. People in high-income countries are more likely to survive due to earlier diagnosis and better access to treatment, while survival is lower in settings with limited healthcare resources.

Risk factors

Being female and increasing age are the strongest risk factors, but breast cancer can affect anyone.

Risk is influenced by a combination of factors:

• Genetics factors, including BRCA1 and BRCA2 mutations
• Family history
• Lifestyle factors such as alcohol use, obesity and physical inactivity
• Hormonal and reproductive factors
• Smoking and radiation exposure

Many people who develop breast cancer have no known risk factors.

Screening and early detection

Early detection is one of the most effective ways to improve survival.

In Sweden:

• Women aged 40–74 are offered regular mammography screening
• Mammography can detect cancer before symptoms develop

Possible symptoms include:

• A lump in the breast or armpit
• Changes in the skin or shape of the breast
• Nipple discharge or pain

While most breast changes are benign, any new, persistent, or unexplained symptoms should be evaluated by a healthcare provider.

Diagnosis and treatment

If breast cancer is suspected, several tests may be used to confirm the diagnosis and determine how far the disease has spread.

This may include:

• Clinical examination of the breasts and lymph nodes
• Mammography and/or ultrasound to assess changes in breast tissue
• Biopsy to confirm the diagnosis
• Additional imaging to determine whether the cancer has spread

In Sweden, patients are investigated through standardized care pathways (SVF), which aim to ensure timely diagnosis and coordinated care.

Treatment is planned by a multidisciplinary team and depends on the type and stage of the disease.

Treatment options may include:

• Surgery, to remove the tumor
• Radiotherapy, often used after surgery
• Chemotherapy
• Hormone therapy or targeted treatments, depending on tumor characteristics

Treatment is often combination-based and tailored to the individual.

Living with and beyond breast cancer

Thanks to advances in care, more people are living long lives after a breast cancer diagnosis. However, survivorship can bring ongoing challenges.

Recovery is a continuous process as many individuals experience:

• Physical effects, such as fatigue or treatment-related side effects
• Emotional impacts, including anxiety, depression, or fear of recurrence
• Changes in daily life, including work, relationships, and social activities

In Sweden, support is available throughout the cancer journey:

• Follow-up care through specialist healthcare teams
• Access to a contact nurse (kontaktsjuksköterska)
• Cancer rehabilitation services, supporting physical, emotional, and social
• recovery
• Patient organizations, offering peer support and practical advice

Fertility and family planning

Breast cancer can affect fertility, particularly in younger patients.

Treatment may impact fertility in several ways:

• Chemotherapy can damage the ovaries and reduce fertility
• Hormone therapy may delay pregnancy for several years
• Some treatments may lead to temporary or permanent infertility

In some cases, fertility preservation options (such as freezing eggs, sperm, or embryos) may be available. Fertility and reproductive health are part of cancer care, and patients can receive individual counselling to support informed decisions.

Reducing inequalities in breast cancer care

Not everyone has the same opportunity for early detection, treatment, and support in breast cancer care. In Europe, differences in breast cancer outcomes are observed both between countries and within populations, even in settings with well-developed healthcare systems.

Key factors include:

• Access to screening and early diagnosis

Participation in mammography screening differs between regions and population groups, with lower attendance among people with lower income, lower education, or those living in rural areas

• Socioeconomic and social factors

Income, education, and living conditions can influence both the risk of cancer and access to timely diagnosis and treatment

• Healthcare systems and resources

Differences in funding, infrastructure, availability of specialists, and access to modern diagnostics and treatments affect outcomes across regions

• Geographical location

Distance to hospitals or specialized cancer centers can delay diagnosis and care

• Health literacy

Awareness of symptoms, screening programs, and how to access care influences when people seek medical help

Because early detection strongly improves outcomes, unequal access to screening and care can increase health inequalities. In Sweden, efforts to reduce inequalities include national screening programs, standardized care pathways, and ongoing work to improve access to care across all population groups.

Research initiatives such as CIRCE contribute to this goal by advancing knowledge on cancer and inequalities, supporting collaboration across disciplines, and helping inform more equitable approaches to prevention, diagnosis, and care.