Significance. Breast cancer remains one of the most common forms of malignant neoplasms. In 2022, approximately 2.3 million new cases were registered worldwide. In the Russian Federation, the incidence rate was 57.7 per 100,000 female population, with a mortality rate of 13.6. An analysis of mortality in the Arkhangelsk region for the period 2010–2024 did not reveal a statistically significant decrease, which may be due to a potential increase in incidence, as well as an insufficient observation period to assess the true effectiveness of screening programs. The purpose of the study. To conduct a comparative analysis of incidence, mortality, active detection rate, advanced-stage cancer rate, and one-year case fatality rate for breast cancer in the Arkhangelsk region and the Russian Federation as a whole, followed by an assessment of the organization of medical care for this patient category. Materials and methods. The study utilized data from the Russian Center for Information Technology and Epidemiological Research in Oncology, the Population-Based Cancer Registry of the Arkhangelsk Regional Clinical Oncology Center, the Federal State Statistics Service (Rosstat), and the Unified Interdepartmental Information and Statistical System (EMISS) for the period 2010–2024. Time series analysis with trend assessment (R²) was applied to identify and visualize trends. Results. During the period 2010–2024, the standardized incidence rate of breast cancer in the Arkhangelsk region increased by 99.5%, which is twice the nationwide growth (49.5%). The active detection rate in the Arkhangelsk region increased by 22.5% (compared to 13.3% in the Russian Federation), and the proportion of cases diagnosed at stages I–II reached 92.5%. However, against the backdrop of a nationwide mortality decrease of 4.6%, an increase of 4.1% was recorded in the Arkhangelsk region. Modern diagnostic methods and organ-preserving operations are being actively introduced in the region (78% in 2024), sentinel lymph node biopsy and reconstructive surgery have been widely introduced, morphological and immunohistochemical verification of the tumor is being carried out, which complies with current clinical recommendations and allows for personalized treatment. Discussion. An increase in the incidence of breast cancer and a decrease in one-year mortality may be associated with a significant increase in active detection rates and the proportion of early stages. However, the 4.1% increase in the mortality rate over the past 15 years indicates that serious problems remain both in the field of diagnosis and, possibly, in providing timely and effective treatment. A possible reason for the increase in mortality is the insufficient coverage and low effectiveness of screening programs, especially in hard-to-reach and sparsely populated areas, as well as the high proportion of aggressive and rapidly progressing subtypes of tumors in young patients. Conclusion. The conducted epidemiological analysis confirms the need for optimization and the development of more effective approaches to the early diagnosis of breast cancer, especially in regions with unfavorable epidemiological conditions.