Abstract: Background: Breast cancer is a common malignant neoplasm worldwide and limited quantitative assessment of the burden of breast cancer has been conducted. We conducted a comprehensive analysis of the disease burden to update the epidemiology of this disease.Methods: Breast cancer data were obtained from the Global Burden of Disease database. Average annual percent change (AAPC) was used to quantify trends of the breast cancer age-standardized rate between 1990 and 2019. Decomposition analysis was used to quantitatively assess the contribution of aging, population growth, and epidemiological changes to the overall breast cancer disability-adjusted life years (DALYs) during this period. Finally, we performed frontier analysis to evaluate the potentially achievable age-standardized DALYs on the basis of socio-demographic index (SDI).Results: Globally, there were 2,002,400 (95% uncertainty interval [UI], 1,832,200 to 2,172,500) incident patients, 700,700 (95% UI, 647,400 to 751,600) deaths, and 20,625,300 (95% UI, 19,043,100 to 22,174,400) DALYs of breast cancer in 2019. Age-standardized incidence rate increased significantly with AAPC of 0.40, while mortality and DALY rates decreased with AAPC of −0.44 and −0.35, respectively. In Oceania, the disease burden was higher than the expected corresponding to its SDI. Decomposition analysis showed that aging and population growth were two major drivers in DALYs. Frontier analysis revealed considerable opportunities to reduce the age-standardized DALYs in the middle of the SDI spectrum.Conclusions: Breast cancer increased substantially from 1990 to 2019 globally. Aging and population growth were major drivers of DALYs in breast cancer. Therefore, targeted strategies should be adopted to reduce the burden of breast cancer.