Breast health. Challenges and promises

There has been significant improvement in breast health care in the United States over the past few decades primarily due to advances in health research by diverse teams of basic scientists, physicians, pharmacists, industries, nurses, and social workers. This research has involved inquiries about fundamental biological alterations in breast cancer, differences in diagnostic modalities, and treatment options and various outcome studies. Increase in public awareness of breast cancer, an interest in women's health issues, advances in radiologic imaging, development of new chemotherapeutic agents and the availability of molecular genetic testings have brought remarkable opportunities to a new insight in breast cancer. These efforts have resulted in earlier detection and prolonged disease-free intervals, however, the overall survival time has remained the same. This is mainly attributable to the wide range of individual therapy for breast cancer, which responds to a range of disease curable by surgery alone to one refractory to treatment and marked by rapid metastatic progression. Challenges remain in fostering adequate funding for biomedical, as well as behavioral and social research. Attempts should also be made to promote clinical and population-based studies and to emphasize the value of effective delivery of health-care services to all women with benign, high risk, premalignant and malignant breast disease.