Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Abstract

In 2012, the estimated age-adjusted annual incidence of breast cancer in 40 European countries was 94.2/100 000 and the mortality 23.1/100 000 [1]. The incidence increased after the introduction of mammography screening, and continues to grow with the ageing of the population. The most important risk factors include: genetic predisposition, exposure to oestrogens (endogenous and exogenous), ionising radiation, low parity and a history of atypical hyperplasia. The Western-style diet, obesity and the consumption of alcohol also contribute to the rising incidence of breast cancer [2]. There is a steep age gradient, with about a quarter of breast cancers occurring before age 50, and <5% before age 35. The estimated 5-year prevalence of breast cancer in Europe in 2012 was 1 814 572 cases [1]. Prevalence is increasing, as a consequence of increased incidence and due to improvements in treatment outcomes. In most Western countries, the mortality rate has decreased in recent years, especially in younger age groups, because of improved treatment and earlier detection [3, 4]. However, breast cancer is still the leading cause of cancer-related deaths in European women.