A roadmap to reduce the incidence and mortality of breast cancer by rethinking our approach to women’s health

Sep 21, 2026

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Despite progress, breast cancer remains the most feared disease among women. In the USA, incidence is approaching 300,000 new cancers per year and has nearly doubled over the last 30 years, with over 40,000 deaths annually. The article highlights disparities in African American women, who face higher mortality, younger diagnosis, and more advanced stage at detection. It proposes a radical prevention shift by rethinking women’s hormonal health interventions, aiming to lower incidence and mortality while improving survivor quality of life through interdisciplinary collaboration.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Introduction

Hormonal interventions and endocrine modulation

Reframing women’s health toward risk reduction

Proposed roadmap initiatives

Breast Cancer Research and Treatment (2025) 209:1–14 [https://doi.org/10.1007/s10549-024-07522-4](https://doi.org/10.1007/s10549-024-07522-4) A roadmap to reduce the incidence and mortality of breast cancer by rethinking our approach to women’s health Katherine Leggat‑Barr1 · Douglas Yee2 · Erin Duralde3 · Caroline Hodge4 · Virginia Borges5 · Molly Baxter6 · Jessica Valdez4 · Tamandra Morgan4 · Judy Garber7 · Laura Esserman4,8 Received: 8 October 2024 / Accepted: 10 October 2024 / Published online: 12 November 2024 © The Author(s) 2024, corrected publication 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. Keywords Breast cancer · Breast cancer risk · Hormonal interventions * Laura Esserman [laura.esserman@ucsf.edu](laura.esserman@ucsf.edu) 1 Tufts Medical School, Boston, MA, USA 2 Masonic Cancer Center Minneapolis, University of Minnesota, Minneapolis, MN, USA 3 One Medical, Los Angeles, CA, USA 4 Department of Surgery, University of California, San Francisco, San Francisco, CA, USA 5 Division of Medical Oncology, University of Colorado Cancer Center, Aurora, CO, USA 6 Johns Hopkins Medical School, Baltimore, MD, USA 7 Dana Farber Cancer Institute, Boston, MA, USA 8 Alfred A de Lorimier Endowed Chair in General Surgery, 1825 4th St, 3rd Floor, San Francisco, CA 94158, USA Introduction A critical and yet untapped approach to reducing breast cancer incidence could come from redesigning the routine hormonal interventions most women use at some point of their lives for symptom amelioration or cycle control, as opportunities to improve breast health. These medical interventions can support broader efforts that are also needed to promote the healthy environments and lifestyles associated with greater health span. We use endocrine modulation for cycle control, contraception, fertility preservation, and menopause symptom management, as well as to treat breast cancer and prevent recurrence. Existing methods are often at odds with eachother. For example, the most common forms of menopausal hormone therapy treat symptoms well but increase the risk of breast cancer by a small amount [1] . Agents such as tamoxifen and aromatase inhibitors reduce breast cancer recurrence and incidence, but cause side effects, though dose reductions in tamoxifen have now been found effective for prevention with minimal side effects. Could a more nuanced

FAQs

What problem does the roadmap address in breast cancer outcomes?

Breast cancer incidence and mortality remain high despite progress, and significant disparities exist in outcomes for African American women, including higher death rates, earlier diagnosis, and more advanced disease stage.

Why do the authors focus on hormonal interventions for prevention?

Most breast cancers are driven by steroid hormones, and throughout life women use hormonal treatments for many health needs. Mixed data suggest these endocrine manipulations could be leveraged to reduce breast cancer risk, yet they are not currently designed explicitly for risk reduction.

What interdisciplinary effort does the article call for?

Scientists, drug developers, breast oncologists, obstetricians, gynecologists, endocrinologists, radiologists, and family medicine/internists should collaborate to reduce breast cancer risk while addressing other critical aspects of women’s health.

Sep 21, 2026

Upload by Aurelia