Breast cancer is the most frequently occurring female cancer, and ranks second overall when cancers of both sexes are considered together. It is still the leading cause of mortality from cancer in women (the 411,000 deaths reported annually represent 14% of all female deaths from cancer worldwide), and is the fifth cancer-related cause of death overall. There were an estimated 1.15 million new breast cancer cases in 2002, of which more than half were in industrialized countries - about 361,000 in Europe (27.3% of female cancers) and 230,000 in North America (31.3%). Incidence rates are highest in the most developed areas, with the highest agestandardized incidence being in North America (99.4 per 100,000). The prognosis from breast cancer is generally good, with the average survival rate in developed countries being 73% and in developing countries 57%. This favorable survival rate in the West is probably a consequence of the introduction of screening programs.
Radical mastectomy has been accepted as an appropriate therapy for breast cancer for a long time. This treatment involves extensive removal of surrounding healthy normal tissue, and often requires a skin graft. However, since the 1970s, an increased understanding of the natural history of breast cancer has led to the consequent use of preservative surgery in the treatment of small breast tumors. Today, breast conservation surgery, combined with radiotherapy, chemotherapy, and/or hormonal therapy, is performed increasingly often in patients with early-stage breast cancer. The move from mastectomy to breast conservation therapy has not affected the long-term survival rates of patients.
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