The incidence of breast cancer: the global burden, public health considerations.

The incidence of breast cancer continues to increase and will reach close to one million new patients annually by the year 2000. The highest age-specific rates occur in developed regions, but more than 50% of cases occur in developing regions. Effective control requires prevention, early diagnosis, and access to effective treatments. Tamoxifen is an important treatment agent and may have a preventative role. Tamoxifen reduces relapse by approximately 25% and deaths by approximately 17%. Tamoxifen has an important role in reducing local recurrence, in reducing the risk of new contralateral breast cancer, and in the treatment of patients with advanced disease. Current trends are largely due to earlier diagnosis, mammographic screening in developed countries, a decrease in deaths in both the United States and the United Kingdom, and an increasing proportion of deaths in developing countries. The total direct medical costs of breast cancer is more than $7 billion per year worldwide. New cost-effective control strategies are required worldwide.