Evolution in the diagnosis and treatment of breast cancer: a PRISMA 2020 systematic review

Abstract

Breast cancer is the most common neoplasm and one of the leading causes of cancer-related mortality in women worldwide, presenting significant challenges in diagnosis, treatment, and prevention. The objective of the study was to systematically and critically review the scientific literature published between 2020 and 2024 on breast cancer, with an emphasis on advances in diagnostics, therapeutics, and the understanding of its risk factors and biomarkers, to identify trends and gaps in current knowledge. A systematic review was conducted following PRISMA 2020 guidelines, analyzing 19 038 articles identified in PubMed, from which 10 key studies were selected based on their relevance, methodological quality, and significant contributions. The results show that the integration of genomic, immunohistochemical, and immunological biomarkers has improved diagnosis and treatment personalization, especially in aggressive subtypes such as triple-negative breast cancer. Prevention is progressing with models integrating factors like mammographic density and polygenic risk, although barriers to implementation persist. Moreover, global disparities in diagnosis and treatment reflect structural inequities, particularly in low-and middle-income countries. Innovations in targeted therapies are expanding options for advanced and metastatic cases. In conclusion, diagnostic and therapeutic strategies for breast cancer have evolved significantly during the studied period, contributing to a more personalized and effective approach, yet challenges related to equity, accessibility, and the global implementation of advancements remain.