Breast Cancer Awareness Month

Breast Cancer Awareness Month encompasses a global series of awareness campaigns held annually from October 1 to 31 to emphasize the importance of early detection and raise awareness about the disease. World Health Organization (WHO) has designated this month since 2004 with the aim of promoting screening and prevention of a disease affecting millions of women worldwide.

These awareness initiatives are carried out by all stakeholders including international organizations civil society groups and academics. The primary goals of the campaigns are to support individuals diagnosed with breast cancer raise public awareness about risk factors emphasize the importance of regular screening and draw attention to the need for further research. Throughout the awareness month the "Pink Ribbon" theme is used globally. Additionally October 15 is recognized as "World Breast Health Day" and October 26 as "Pink Ribbon Day" to highlight the importance of early detection.

Breast cancer is a chronic disease characterized by the uncontrolled growth of cells in breast tissue. Chronic cancer typically originates in the milk-producing glands (lobules) or milk ducts (ducts) of the breast and less commonly develops in the fatty or connective tissue of the breast.

• Global Prevalence: Breast cancer is the most common cancer among women worldwide. According to WHO data from 2021 it accounts for 11.7% of all newly diagnosed cancers making it the leading cancer type. Approximately 2.3 million women are diagnosed with breast cancer each year representing 23.8% of all new cancer cases in women. In 2022 approximately 670000 women died from this disease.^【1】
• Situation in Türkiye: In Türkiye breast cancer is the most common and leading cause of cancer-related death among women. According to Ministry of Health data approximately 27000 women are diagnosed with breast cancer annually and one in every 18 women faces a lifetime risk of developing the disease. Breast cancer accounts for approximately 25% of all cancers in women.^【2】

The development of breast cancer involves an interplay of genetic susceptibility and environmental factors. For all invasive breast tumors 62.8% of risks are attributed to modifiable factors and 37.2% to non-modifiable factors.^【3】

• Leading a sedentary or inactive lifestyle.
• Being overweight or obese (especially gaining more than 5 kg after menopause).
• Using tobacco and tobacco products and alcohol.
• Never having given birth or becoming a mother after age 35.
• Never breastfeeding.
• Using hormone therapy for more than two years after menopause (HRT).

• Being female: Breast cancer occurs about 100 times more frequently in women than in men.
• Increasing age: Risk increases after age 40.
• Having certain genes (such as BRCA1 and BRCA2).
• Family history: Having a first-degree relative (mother sister or daughter) with breast cancer doubles the risk. However approximately 85% of breast cancer cases occur in women with no family history of the disease which is linked to genetic mutations occurring with aging.^【4】
• Having had cancer in one breast previously.
• Having dense breast tissue.
• Early onset of menstruation (before age 12) or late menopause (after age 55).
• Having received radiation therapy to the chest area.

To reduce the risk of breast cancer healthy lifestyle habits are recommended including a diet rich in vegetables and fruits regular physical activity maintaining a healthy weight and avoiding tobacco and alcohol. Additionally since breastfeeding has a protective effect all mothers are advised to breastfeed their infants for at least two years.

The most common symptom of breast cancer is the detection of a painless lump or mass in the breast that grows over time. The disease may not present any symptoms until advanced stages. Other possible symptoms include:

• Changes in the shape or size of the breast.
• Redness thickening scaling or an orange peel-like appearance of the breast or nipple skin.
• Discharge from the nipple (especially bloody discharge).
• Retraction or inward turning of the nipple or skin.
• Swelling or lump under the armpit or around the collarbone (sometimes appearing before a lump is felt in the breast).

If any of these symptoms are observed it is crucial to seek medical attention without delay.

An effective strategy in combating breast cancer is detecting the disease at an early stage because early diagnosis leads to higher treatment response rates and is life-saving. Treatment of breast cancers detected at early stages is more successful and improves quality of life.

In Türkiye the Ministry of Health implements cancer screening programs under the National Cancer Control Program. These free screening services comply with European Union quality standards and are delivered through Cancer Early Diagnosis Screening and Education Centers (KETEM) Family Health Centers (ASM) Healthy Life Centers (SHM) Community Health Centers (TSM) and mobile cancer screening units.

The National Breast Cancer Screening Standards recommend three primary methods for early detection: Breast Self-Examination (BSE) which is recommended monthly for women starting at age 20 (7 to 10 days after the start of menstruation). Clinical Breast Examination should be performed by a physician every two years for women aged 20 to 39. Finally Mammography (Imaging) is offered free of charge every two years to all women aged 40 to 69 regardless of symptoms; this screening typically involves taking two standard views (MLO and CC) of each breast.

Breast cancer is a disease that can present with different characteristics in each patient. Therefore treatment plans are personalized based on the patient's age cancer stage genetic profile and other health conditions. Multiple factors including tumor location stage and presence of other health issues influence treatment decisions.

Major treatment approaches include surgery chemotherapy (drug therapy) radiation therapy hormone therapy and targeted or immunotherapy.

Survival rates for early-diagnosed cases can reach up to 90%. National cancer statistics show that a large proportion of newly diagnosed breast cancers (48.2% or 42.9%) are localized meaning confined to the breast while a small proportion (10.2% or 12.5%) are detected with distant metastasis.^【5】