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The review synthesizes advances in molecular pathogenesis, targeted therapy, screening, and prevention, addressing resistance mechanisms, emerging targets, and improved risk stratification. 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Prevention  \nHuijun Lei1, 2   Jinzhen Fu1, 3  Wei Gu1, 3  Hongjin Qiao1, 3  Huixue Guo1, 4  Zijian Chen1, 3   San Ming Wang2 Tianhui Chen1  \n1 Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China  2 Faculty of Health Sciences, University of Macau, Taipa, Macau, China  3 Postgraduate Training Base Alliance of Wenzhou Medical University  \n(Zhejiang Cancer Hospital), Wenzhou, Zhejiang, China  4 Hangzhou Normal University, Hangzhou, Zhejiang, China Correspondence: Tianhui Chen ([chenth@zjcc.org.cn](chenth@zjcc.org.cn))  \nReceived: 31 October 2024  Revised: 21 November 2025  Accepted: 28 November 2025  \nKeywords: breast cancer | pathogenesis | targeted therapy | screening | prevention | risk assessment  \nABSTRACT  \nBreast cancer is the most common cancer and the leading cause of cancer-related death among women worldwide. Advancesin molecular biology, high-throughput sequencing, and integrative-omics have deepened the understanding of its heterogeneity by clarifying mechanisms linked to genetic susceptibility, epigenetic regulation, oncogenic signaling, and immune evasion. Although those developments have driven progress in targeted therapy and screening, concerns on drug resistance, toxicity, global inequities, and suboptimal risk stratification continue to limit outcomes. This review systematically summarizes current advances across four interconnected areas of breast cancer research and management, including molecular pathogenesis, targeted therapy, screening, and prevention. It describes key biological processes that shape tumor heterogeneity and examines targeted therapies, including endocrine agents, HER2-directed drugs, CDK4/6 and PI3K/AKT/mTOR inhibitors, antibody–drug conjugates, and immunotherapies, together with mechanisms of resistance and emerging treatment targets. It also evaluates evolving approaches in risk stratification and screening, highlighting progress in digital breast tomosynthesis, magnetic resonance imaging, contrastenhanced mammography, and artificial intelligence-assisted interpretation. By integrating cutting-edge molecular insights with clinical advances, this review further highlights the expanding opportunities for personalized therapy and precision prevention. It outlines future directions linking multiomics and artificial intelligence to more equitable and effective breast cancer management.  \n1  Introduction  \nBreast cancer is the most common cancer and the leading cause of cancer-related mortality among women worldwide, imposing a significant economic and social burden on healthcare systems [1] . Recent data show a continuing increase in breast cancer incidence [2], driven in part by improved screening capabilities [3] . In 2022, approximately 2.3 million new cases and 670,000 deaths were reported globally, accounting for 25% of new cancer  \ndiagnoses and 15.5% of cancer deaths among women. Globally, breast cancer accounts for one in four female cancers and one in six female cancer-related mortality [1] . By 2050, projected incidence shall increase by 38% while mortality shall increase by 68%, with the heaviest burden expected in countries with low scores of human development index scores [4] .  \nBreast cancer is a heterogeneous disease encompassing multiple subtypes with distinct molecular and clinical features. Current  \n\n| Huijun Lei, Jinzhen Fu, Wei Gu contributed equally to this work as cofirst authors.\u003Cbr>|\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2026 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd. |\n\nMedComm, 2026; 7:e70560  \n[http","cbCaity3gqkAIvkF","https://ap.wps.com/l/cbCaity3gqkAIvkF","pdf",3899721,41,"English","# Introduction\n# Molecular Pathogenesis\n# Targeted Therapy\n# Screening and Risk Stratification\n# Prevention and Future Directions","[{\"question\":\"What are the main areas covered by this review on breast cancer?\",\"answer\":\"The review covers four interconnected areas: molecular pathogenesis, targeted therapy, screening, and prevention, with emphasis on how these domains inform each other for management improvements.\"},{\"question\":\"Which targeted therapies and treatment strategies are discussed?\",\"answer\":\"It discusses endocrine agents, HER2-directed drugs, CDK4/6 and PI3K/AKT/mTOR inhibitors, antibody–drug conjugates, and immunotherapies, including the mechanisms behind drug resistance and emerging targets.\"},{\"question\":\"How does the review address screening and risk stratification?\",\"answer\":\"It evaluates evolving approaches in risk stratification and screening, emphasizing progress in digital breast tomosynthesis, magnetic resonance imaging, contrast-enhanced mammography, and AI-assisted interpretation.\"}]","Breast Cancer - Molecular Pathogenesis, Targeted Therapy, Screening, and Prevention | PDF",1790742361,103]