Breast cancer burden risk attribution and productivity loss in Chinese women aged 25 to 49.

Breast cancer among Chinese women aged 25-49 years has substantial clinical and societal consequences. We integrated Global Burden of Disease (GBD) 2023 estimates for 1990-2023 with Global Cancer Observatory (GLOBOCAN) 2022, United Nations population projections, International Labour Organization labour-force participation, and World Bank indicators. Incident cases rose from 50,064 to 87,221, while the weighted death rate declined from 9.25 to 4.72 per 100,000. Demographic changes explained 63.0% of additional cases. In exploratory extreme gradient boosting (XGBoost) analyses interpreted with SHapley Additive exPlanations (SHAP), the fasting-plasma-glucose-related population attributable fraction (PAF) ranked first in several formulations but weakened after removing age and temporal structure; the selected high-body-mass-index (BMI) PAF series was constant at zero and unrankable. Potential mortality-related productivity loss was US$6.161 billion in 2023. Status-quo projections suggested increasing incidence through 2050 with very wide uncertainty, supporting surveillance and individual-level validation rather than immediate screening policy changes.