Management of breast cancer--Part I

Breast cancer remains the second most common cause of cancer related death in women in the United Kingdom, with over 12 000 deaths a year.However, substantial progress is being made: deaths from breast cancer in the Western world have fallen by over 25% in the past two decades, 1 reflecting substantial improvements in management (fig 1).Incidence in Great Britain has risen by 50% over the past three decades, reflecting not only changes in population demographics and environmental factors but also an increase in diagnosis as a result of screening.Over a similar time period mortality has fallen.We review here the recent advances in the prevention, screening, and treatment of breast cancer and the recent efforts to individualise treatment.The review is published in two parts; in the second part we will review advances in the systemic treatment of breast cancer and how an increasing understanding of the biology of breast cancer is beginning to change the way we treat the disease.