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In the USA alone, the incidence is now almost 300,000 new cancers per year, a rate that has nearly doubled in the last 30\u00a0years. Most women survive, but over 40,000 women a year still die of their disease [99]. It is the most diagnosed cancer among women and the second leading cause of cancer death. Important disparities exist in breast cancer outcomes among African American women, where women die of breast cancer at higher rates, are diagnosed younger, and at a more advanced stage. We are proposing a radical shift in our thinking about breast cancer prevention\u00a0with an aspiration to dramatically lower breast cancer\u00a0incidence. Most breast cancers are driven by steroid hormones. Throughout the life course, women are offered an array of hormonal treatments for menstrual cycle control, family planning, in vitro fertilization, postpartum weaning, and menopausal symptom management. There are mixed data on the extent to which each of these may contribute to increased or decreased risk for breast cancer. These endocrine manipulations could represent a great opportunity to potentially reduce breast cancer incidence and improve quality of life for survivors. To date, they have not been designed to explicitly reduce breast cancer risk. A new holistic approach will require scientists, drug developers, breast oncologists, obstetricians, gynecologists, endocrinologists,\u00a0radiologists, and family medicine\/internists to work together toward the common goal of reducing breast cancer risk while addressing other\u00a0critical issues in women\u2019s health.<\/jats:p>","DOI":"10.1007\/s10549-024-07522-4","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T04:37:54Z","timestamp":1731386274000},"page":"1-14","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A roadmap to reduce the incidence and mortality of breast cancer by rethinking our approach to women\u2019s health"],"prefix":"10.1007","volume":"209","author":[{"given":"Katherine","family":"Leggat-Barr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Yee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Duralde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Hodge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Borges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Baxter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Valdez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamandra","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Garber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9202-4568","authenticated-orcid":false,"given":"Laura","family":"Esserman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"issue":"3","key":"7522_CR1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1001\/jama.288.3.321","volume":"288","author":"Writing Group for the Women\u2019s Health Initiative Investigators","year":"2002","unstructured":"Writing Group for the Women\u2019s Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal womenprincipal results from the women\u2019s health initiative randomized controlled trial. 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CH reports institutional research funding from AstraZeneca, Gilead, Seagen\/Pfizer and Olema; individual consulting fees for running ad boards, moderating lectures, speaking\/presenting fees from AstraZeneca, Seagen\/Pfizer, Gilead and Olema; and travel support from Olema. JG is an executive employee of Dana Faber Cancer Institute; participation on Fiduciary Board at American Association for Cancer Research; and participation on the Scientific Advisory Board at The James P. Wilmot Foundation, Inc. and Earli Inc. LE reports funding from Merck & Co.; participation on an advisory board for Blue Cross Blue Shield; and personal fees from UpToDate; unpaid board member of QLHC. All other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}