Breast cancer now represents the most common female malignancy in both the developing and developed world, and is the primary cause of death among women globally. Despite well-documented reductions in mortality from breast cancer during the past two decades, incidence rates continue to increase and do so more rapidly in countries that historically had low rates. This has emphasized the importance of survivorship issues and optimal management of disease chronicity. This article reviews current trends of incidence and mortality in both a western and global context, and considers pertinent changes in underlying etiological risk factors. The latter not only offer clues regarding changes in incidence patterns, but also provides rationale and guidance for strategies that could potentially reduce the burden of this disease. The relevance of lifestyle adjustments and screening interventions for primary and secondary prevention, respectively, are discussed with reference to different healthcare resource settings.