Breast cancer is the most frequently diagnosed cancer in women and the second leading cause of cancer mortality. It is estimated to account for approximately 20% of all cancer expenditures, making the burden of disease relatively high. One of the most important risk factors for developing breast cancer is age; with demographic trends towards an increasing elderly population in the US, this burden is likely to increase. Recent trends in healthcare delivery have increased the emphasis on evaluating costs of providing care as well as the outcomes of that care.This paper reviews breast cancer epidemiology, primary and secondary prevention and costs of breast cancer care by stage of disease at diagnosis and type of service, and discusses implications for the development of disease management programmes. Implementation of disease management programmes, through the creation of a data infrastructure system, establishment of measurable breast health and cancer care outcomes, and programme evaluation may be an important mechanism for managed-care organisations to provide quality and cost-effective breast cancer management.