Objective To analyze the disease burden, risk factor attribution, and trends through 2030 of female breast cancer in China from 1990 to 2023. MethodsBased on data from the Global Burden of Disease Study 2023, the average annual percent change (AAPC) was used to evaluate long-term trends. An age-period-cohort (APC) model was applied to assess age, period, and cohort effects. Population attributable fractions, attributable disability-adjusted life years (DALYs), and decomposition analysis were used to evaluate the contributions of risk factors. A Bayesian APC model was used to project trends from 2024 to 2030. ResultsFrom 1990 to 2023, the age-standardized incidence rate of female breast cancer in China increased from 24.54 per 100 000 to 31.62 per 100 000, whereas the age-standardized mortality rate decreased from 10.65 per 100 000 to 6.74 per 100 000 and the age-standardized DALY rate decreased from 372.92 per 100 000 to 228.43 per 100 000. The AAPCs in incidence rates were negative among women aged 15–39 years (P<0.05) and became positive after 45 years of age (P<0.05), with the largest increase observed in the 85–89 year age group (AAPC=1.72%). In the ≥95 year age group, mortality, DALY, and years of life lost rates all increased, with AAPCs of 0.58%, 0.52%, and 0.52%, respectively (P<0.05). APC analysis showed that the net drift in age-specific incidence rates was 0.315% per year (P<0.001), whereas the net drift in age-specific mortality rates was ?2.316% per year (P<0.001). In 2023, the leading attributable risk factors were high red meat intake, secondhand smoke, high fasting plasma glucose, high body mass index, and low physical activity. Bayesian APC projections indicated that the age-standardized incidence, mortality, and DALY rates would reach 38.91 per 100 000, 7.84 per 100 000, and 244.24 per 100 000, respectively, by 2030. ConclusionsThe incidence burden of female breast cancer in China continued to increase, whereas the age-standardized mortality and premature mortality burdens declined over the long term but showed a recent rebound. The disease burden increasingly shifted toward older women, and the overall burden is expected to remain substantial through 2030.