Breast Cancer Awareness Month

Breast Cancer Awareness Month encompasses a series of global awareness campaigns held annually from October 1 to 31 to highlight the importance of early detection and raise awareness about the disease. Designated by World Health Organization (WHO) since 2004, this month aims to encourage 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 "Wear the Pink Ribbon Day" to underscore the importance of early detection.

Breast cancer is a chronic disease characterized by the uncontrolled growth of cells in breast tissue. Cancer typically originates in the milk-producing glands of the breast (lobules) or the ducts that carry milk (ducts) and less frequently 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 has risen to the top position among cancer types accounting for 11.7% of all newly diagnosed cancers. 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 also 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 between 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 (obese) particularly 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 (late childbirth).
• Never breastfeeding.
• Using hormone therapy for more than two years after menopause (HRT).

• Being female: Women are 100 times more likely to develop breast cancer than men.
• Advancing age: Risk increases after age 40.
• Possessing certain genes (BRCA1 BRCA2 among others).
• Family history: Having breast cancer in a first-degree relative (mother sister or daughter) doubles the risk. However approximately 85% of breast cancer cases occur in women with no family history a phenomenon linked to genetic mutations arising with aging.^【4】  
• Having had cancer in one breast previously.
• Having dense breast tissue.
• Early 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 all mothers are advised to breastfeed their infants for at least two years due to its protective effect.

The most common symptom of breast cancer is the presence of a painless lump or mass in the breast that grows over time and can be felt. The disease may not present any symptoms until it reaches advanced stages. Other possible signs 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).
• Dimpling or retraction of the nipple or breast skin.
• Swelling or lump in the armpit or around the collarbone (sometimes appearing before a lump is felt in the breast).

It is essential to seek medical attention immediately if any of these symptoms are observed.

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 outcomes are more successful and quality of life improves when breast cancer is detected in its early stages.

In Türkiye the Ministry of Health implements cancer screening programs under the National Cancer Control Program. These free screening services 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 in accordance with European Union Quality Standards.

The National Breast Cancer Screening Standards recommend three primary methods for early detection: Self-Breast Examination (SBE) which is advised for women aged 20 and older to perform monthly (7–10 days after the start of menstruation). Clinical Breast Examination should be conducted by a healthcare provider 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 the location and stage of the disease and the presence of other health issues influence treatment decisions.

Main treatment approaches include surgery chemotherapy (drug therapy) radiation therapy hormone therapies and targeted or immunotherapies.

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