Breast Cancer FAQs 

1. What is the lifetime risk of breast cancer?
   The lifetime risk for women in the U.S. is about 1 in 8, meaning it is among the most common cancers. At a biological level, this reflects cumulative mutations in breast epithelial cells influenced by hormonal and environmental exposures. Advances in screening and therapy since the 1980s have lowered mortality, showing how prevention and treatment science evolve together.
   
   

2. How common is breast cancer today?
   Breast cancer remains the most frequently diagnosed cancer in women after skin cancers. Surveillance data show incidence is rising in younger women under age 50, highlighting shifting epidemiology. This suggests genetic, lifestyle, and environmental factors may be acting earlier than previously recognized, requiring earlier vigilance.
   
   

3. Which groups face higher mortality?
   Black women experience the highest breast cancer mortality despite equal or lower incidence compared to White women. This is partly due to a higher proportion of aggressive subtypes like triple-negative disease. However, social determinants—such as access to early diagnosis and guideline-concordant treatment—play an equally significant role.
   
   

4. What drives risk beyond BRCA mutations?
   Beyond hereditary BRCA1/2 variants, risk is influenced by age, dense breast tissue, alcohol, obesity, and reproductive patterns. Polygenic risk scores and imaging-based AI models now capture subvisual signals to refine predictions. This integration of genomics, radiology, and epidemiology reflects the future of individualized risk assessment.
   
   

5. How effective is mammography?
   Mammography reduces mortality by detecting tumors at Stage I, when 5-year survival exceeds 99%. Digital breast tomosynthesis (3D mammography) improves sensitivity in dense breasts. The balance is minimizing false positives while maximizing early detection—an area where AI tools are now being tested.
   
   

6. What is MIRAI?
   MIRAI is a deep learning model created at MIT that predicts risk from mammograms across multiple years of imaging. It integrates temporal changes and remains predictive even if clinical data are incomplete. Prospective trials suggest it identifies high-risk women years before standard density-based risk models, a leap toward precision screening.
   
   

7. Are most mammogram abnormalities cancer?
   No—most findings are benign changes such as cysts or fibroadenomas. Radiologists classify findings using BI-RADS categories, which guide follow-up from repeat imaging to biopsy. Understanding this helps patients contextualize anxiety about callbacks: early investigation prevents missed cancers while avoiding unnecessary procedures.
   
   

8. What are the current main therapies?
   Treatment depends on molecular subtype (ER, PR, HER2, triple-negative). Surgery and radiation remain the backbone, with targeted therapies like HER2 inhibitors and CDK4/6 inhibitors improving survival. Immunotherapy has recently entered care for PD-L1 positive triple-negative disease, showing how precision oncology tailors regimens.
   
   

9. Do men get breast cancer?
   Yes, though it represents ~1% of all breast cancers. Male breast cancer is often diagnosed later due to lack of awareness. BRCA2 mutations strongly predispose men, making genetic counseling critical when family history exists.
   
   

10. How does obesity influence risk?
    In postmenopausal women, fat tissue becomes the primary source of estrogen, fueling hormone-sensitive tumors. Obesity also increases chronic inflammation and insulin resistance, both linked to cancer biology. Thus, weight management and exercise serve as both general health strategies and cancer-preventive measures.
    
    

11. What is the survival outlook?
    Localized breast cancer has a 5-year survival of ~99%. However, survival drops with regional or metastatic spread, underscoring the importance of early detection. Population-level survival improvements also reflect adjuvant endocrine and targeted therapies.
    
    

12. What health system actions are most important?
    Ensuring timely biopsy, providing access to cutting-edge therapies, and embedding patient navigation programs improve survival. Addressing racial and geographic disparities reduces preventable mortality. At a systems level, this requires aligning public health, oncology, and payer priorities to improve equity.
    
    

References (Breast Cancer):

• American Cancer Society. Cancer Facts & Figures 2025. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures.html
  
  

• SEER Cancer Stat Facts: Breast Cancer. https://seer.cancer.gov/statfacts/html/breast.html
  
  

• BCRF – Regina Barzilay, AI and breast cancer risk prediction. https://www.bcrf.org/researchers/regina-barzilay/
  
  

Liver Cancer FAQs 

1. How common is liver cancer in the U.S.?
   Liver cancer incidence is ~9.4 per 100,000 and mortality ~6.6 per 100,000. Men are affected more than women, partly due to differences in viral hepatitis exposure and alcohol use. The global burden is even higher, especially in Asia and Africa.
   
   

2. Why is prevention important?
   Most liver cancers are hepatocellular carcinoma (HCC), often diagnosed too late for cure. Prevention (vaccines, antiviral therapy, reducing alcohol) is more effective than late-stage treatments. This is a prime example of “public health as oncology.”
   
   

3. What are major risk factors?
   Chronic HBV and HCV infection, alcohol, MASLD, aflatoxin exposure, diabetes, and obesity. These act through cirrhosis, which creates a pro-oncogenic environment. Knowing risk factors guides who to surveil with ultrasound.
   
   

4. Are most cases preventable?
   Yes—modeling shows up to 60% are preventable. This includes HBV vaccination, HCV cure with antivirals, reducing alcohol, and weight management. This places HCC among the most “policy-preventable” cancers.
   
   

5. Who needs surveillance?
   All patients with cirrhosis and select HBV carriers need semiannual ultrasound ± AFP. Surveillance enables detection at curable stages. Adherence is a major challenge, requiring structured programs.
   
   

6. What are first-line treatments?
   Curative options: resection, ablation, transplant. For intermediate disease: TACE or TARE. For advanced: systemic therapies, now often IO + TKIs in combination.
   
   

7. How does MASLD affect risk?
   As viral hepatitis declines, MASLD rises, especially in the U.S. HCC can arise in MASLD without cirrhosis, complicating surveillance algorithms. This is an emerging challenge in hepatology.
   
   

8. What about cholangiocarcinoma?
   Intrahepatic cholangiocarcinoma arises from bile ducts, often detected late. PSC and flukes are major risks. Molecular testing can identify actionable targets.
   
   

9. What is the role of vaccination?
   HBV vaccination is one of the most effective cancer-preventive interventions globally. Countries with universal HBV vaccines show lower HCC decades later.
   
   

10. How does alcohol policy influence outcomes?
    Population-level alcohol regulation decreases cirrhosis and HCC rates. Clinically, even brief interventions in primary care reduce heavy drinking and downstream liver risk.
    
    

11. What equity issues exist?
    Underserved groups have higher viral hepatitis prevalence and less access to antivirals and transplant. Addressing this is essential for cancer equity.
    
    

12. What should clinicians emphasize in counseling?
    Screen for HBV/HCV, vaccinate, treat infections, manage MASLD, and maintain surveillance. Preventive care is the most impactful oncology strategy in liver disease.
    
    

References (Liver Cancer):

• SEER Cancer Stat Facts: Liver & Intrahepatic Bile Duct Cancer. https://seer.cancer.gov/statfacts/html/livibd.html
  
  

• The Lancet Commission on Liver Cancer Prevention. https://pubmed.ncbi.nlm.nih.gov/38678174/
  
  

• American Cancer Society. Liver Cancer Facts. https://www.cancer.org/cancer/liver-cancer/about/key-statistics.html