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Breast Cancer Facts and Stats

Breast cancer is the most frequently diagnosed cancer in U.S. women, excluding cancers of the skin. If the current rate stays the same, women born today have about a 1 in 8 chance of developing breast cancer at some point during their lives.1 Although mortality rates have steadily decreased over the past decades, breast cancer remains the second leading cause of cancer deaths in U.S. women, exceeded only by lung cancer.2

Key Statistics:

  • In 2013, an estimated 232,340 new cases of invasive breast cancer will be diagnosed in U.S. women. In addition to invasive breast cancer, an estimated 64,640 cases of carcinoma in situ (CIS) will be diagnosed.2
  • In 2013, an estimated 39,620 U.S. women will die from breast cancer.2
  • The risk of getting breast cancer increases with age. Approximately 77% of women with breast cancer are over the age of 50 at the time of diagnosis.3
  • Although overall incidence is highest for Caucasian women, African Americans have the highest mortality rate from breast cancer. Caucasian women have the second highest mortality rate, followed by American Indian/Alaska Natives, Hispanic/Latinos, and Asian American/ Pacific Islanders.4
  • The breast cancer mortality rate has decreased since 1989, with larger decreases in women younger than 50. The decline is attributed to earlier detection, improved treatments, and possibly, decreased incidence as a result of declining use of postmenopausal hormone therapy.5
     
  • When detected and treated early, 5-year relative survival for localized breast cancer is 98%. For regional disease, it is 84%. If the cancer has spread to distant organs, 5-year survival drops to 24%.5 Larger tumor size at diagnosis is also associated with decreased survival.4
  • As of 2012, there were an estimated 2.9 million breast cancer survivors living in the U.S.2

Risk Factors:

  • Gender: Female gender is the most important risk factor for breast cancer. Men can develop breast cancer, but the risk for females is about 100 times greater.2
     
  • Age: As women age, the risk of developing breast cancer increases. About 66% of all invasive breast cancers are diagnosed in women age 55 and older, while about 12% are diagnosed in women younger than age 45.2 
  • Race and ethnicity: In the U.S., Caucasian women are slightly more likely to develop breast cancer than are African-American women, although African Americans are more likely to die from this disease. Asian, Hispanic, and Native-American women have a lower risk than either Caucasian or African American women of developing and dying from breast cancer.2
  • Family history of breast cancer: Risk is increased for women whose close relatives have breast cancer. In general, the more biological relatives with breast cancer, especially relatives diagnosed before age 50, the higher a woman's risk. Less than15% of women with breast cancer have a positive family history in a first degree relative.2
  • Genetic factors: Certain gene mutations strongly increase a woman's risk. An estimated 5% to 10% of all breast cancers are directly attributable to inherited gene mutations, most often to mutations in the BRCA1 or BRCA2 genes. In the U.S., BRCA mutations are more common in Jewish women of Ashkenazi origin, but they can occur in any racial or ethnic group. Mutations in the genes ATM, TP53, CHEK2, PTEN, CDH1, STK11 also increase breast cancer risk, but these are much rarer and do not increase risk as much as BRCA genes.2
  • Benign breast conditions: There is a slight to strong increase in risk for women with certain types of abnormalities found with a breast biopsy, depending upon the type of abnormality. Non-proliferative lesions may have a slight effect on breast cancer risk. Proliferative lesions without atypia increase risk 1½ to 2 times normal. Proliferative lesions with atypia (i.e., ADH, ALH) increase a woman's risk by 3½ to 5 times.2
  • Personal history of breast cancer: A history of breast cancer in one breast increases the risk of developing a new cancer in the other breast or in another part of the same breast by 3 to 4 times.2
  • Dense breasts: Women whose mammograms show a large area of dense breast tissue (usually defined as ≥ 75%) are at 4 to 5 times higher risk than same aged women with less or no dense breast tissue.3 Dense breast tissue can also make it harder to detect breast cancer with mammography.2
  • Reproductive history: Certain reproductive factors slightly increase risk. These include giving birth to a first child after age 30, nulliparity (never having children), starting menstruation before age 12, and/or entering menopause after age 55.2 The increase in risk is likely due to a longer lifetime exposure to estrogen.7
  • Hormone therapy after menopause (also called hormone replacement therapy, or HRT): Using combined hormone therapy after menopause (estrogen and progesterone) increases breast cancer risk for current or recent users, especially if used for longer than 2 to 3 years. The use of estrogen alone after menopause does not appear to increase the risk of developing breast cancer; however, when used long term (> 10 years) it may increase risk for ovarian cancer per some studies. Both combined hormone therapy and estrogen therapy alone also appear to increase the risk of heart disease, blood clots, and strokes.2
  • Radiation therapy to the chest when young: Risk is strongly increased for women treated with radiation to the chest for another cancer as children or young adults (as with Hodgkin's lymphoma). The risk is highest for those treated during adolescence, when the breasts are still developing. The most vulnerable ages appear to be between ages 10 to 14.6
  • Weight: Excess weight (as measured by body mass index) and/or weight gain after menopause is associated with a higher risk of breast cancer. In contrast, excess weight in premenopausal women has been associated with a lower risk. The reason for this observed relationship in premenopausal women is unclear.6
  • Alcohol: Compared with non-drinkers, women who drink alcoholic beverages are at increased risk. The risk increases with the amount of alcohol consumed. Risk for those who consume 2 to 5 drinks daily is increased by about 1½ times normal.2
  • Height: Height has been associated with an increased risk of breast cancer in a majority of studies. Risk is about 20% greater for women 69 inches or taller as compared with women less than 63 inches tall.6
  • Other factors: Exposure to certain environmental substances and conditions may also increase a woman's risk of developing breast cancer. Currently there is conflicting evidence regarding the risk of environmental exposure to organochlorines (some exert a weak estrogenic effect), tobacco smoke, as well as night shift work. Research is ongoing in these and other areas of our current environment with potential for effecting breast cancer risk.2

Risk Reduction: 

For women at average risk, the emphasis is on regular screening and healthy lifestyle choices (e.g., low-fat diet, regular exercise, breastfeeding). Women at increased risk for breast cancer are advised to consider additional risk reduction strategies in consultation with their health care providers.

  • Physical activity: Regular physical exercise has been shown to provide some protection against breast cancer, especially in postmenopausal women. The reduction in risk for physically active women compared with women who are least active may be as much as 25%.6
  • Diet: A diet that is rich in vegetables, fruit, poultry, fish, and low-fat dairy products has been associated with a lower risk of breast cancer in some studies.2 There is also some evidence that soy-rich diets may reduce risk.6 Overall, however, the influence of dietary factors on breast cancer risk remains inconclusive.
  • Breastfeeding: The risk reducing effect of breastfeeding has been shown in multiple studies, especially if the breast-feeding lasts 1½ to 2 years.2 For every year of breastfeeding, the reduction in relative risk has been estimated at approximately 4%.6

Screening Guidelines:

The US Preventative Services Task Force (USPSTF) recommends that biennial screening mammography begin at age 50 for women at average risk. The Task Force states that the decision to start mammography screening before the age of 50 should be an individual one and take into account the patient's situation, including her values regarding the benefits and harms of screening. For older women, the USPSTF maintains that the current evidence is insufficient for assessing the additional benefits of screening mammography in women past age 74.

Similarly, with regard to clinical breast examination, the Task Force believes that there is insufficient evidence for assessing the additional benefits of clinical breast examination beyond screening mammography in women 40 years or older. The USPSTF recommends against clinicians teaching women how to perform breast self-examination (BSE), stating that evidence suggests that teaching BSE does not reduce breast cancer mortality.8

The American Cancer Society (ACS) advocates for annual screening mammography, beginning at age 40 and continuing for as long as a woman is in good health. Clinical breast examination every three years is recommended for women in their 20s and 30s, and annually for women aged 40 and older. Breast self-exam is an option for women starting in their 20s. Women who choose to do BSE should receive instruction from their health providers. Women at increased risk for breast cancer may benefit from earlier initiation of screening, screening at shorter intervals, and screening with additional methods such as ultrasound or magnetic resonance imaging.910

Comparison of USPSTF and ACS
Screening Guidelines
USPSTF
ACS
Biennial screening mammography beginning at age 50. Annual screening mammography beginning at age 40.
Evidence is insufficient for assessing the additional benefits of screening mammography in women past age 74. Continue annual screening mammography for as long as a woman is in good health.
Recommends against clinicians teaching women how to perform breast self-examination. Breast self-examination is optional. Women who choose to do breast self-examination should receive instruction from their health providers.
Evidence is insufficient for assessing the additional benefits of clinical breast examination beyond screening mammography in women 40 years or older. Recommends clinical breast examination every three years for women in their 20s and 30s, and annually for women aged 40 and older.
Evidence is insufficient for assessing the additional benefits and harms of MRI as a screening method for breast cancer. In addition to screening mammography, annual MRI screening is recommended for women with greater than 20% lifetime risk of breast cancer.

For information on cancer screening services for medically underserved women:

Breast and cervical cancer screening services are available to medically underserved women living in the United States through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). This national program is sponsored by the Centers for Disease Control and Prevention (CDC) and provides access to free or low-cost screening for eligible women.

In California, the Every Woman Counts (EWC) program assists low income, uninsured, underserved women in obtaining high quality breast and cervical cancer screening and follow-up services. The program is administered by California Department of Health Care Services. EWC receives funding from the Centers for Disease Control and Prevention (CDC), National Breast and Cervical Cancer Early Detection Program (NBCCEDP), Proposition 99, one cent of a two-cent tax on tobacco products (mandated by the California Breast Cancer Act of 1993), and general funds.

Women who would like to find out if they qualify for the program may call 1-800-511-2300 Monday - Friday, from 8:30 AM to 5 PM. The EWC representative for your area may know of other low-cost screening programs that might be available to you. Regional Contractors are also your link to support groups, advocacy groups and the latest information on what's happening in your community.

References:

1National Cancer Institute (NCI). (2012, Sep. - Last reviewed). Breast cancer risk in American women. Accessed Jul. 30, 2013, from http://www.cancer.gov/cancertopics/factsheet/detection/probability-breast-cancer

2American Cancer Society (ACS). (2013, Feb. - Last revised). Breast cancer: detailed guide. Accessed Jul. 30, 2013, from http://www.cancer.org/cancer/breastcancer/detailedguide

3 U.S. Department of Health and Human Services (USDHHS). (2008, Aug. - Last revised). Preventing chronic diseases: Investing wisely in health - screening to prevent cancer deaths. Accessed Jul. 30, 2012, from http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/cancer.pdf

4American Cancer Society (ACS). (2011). Breast cancer facts & figures 2011-2012. Accessed Jul. 30, 2013, from http://www.cancer.org/research/cancerfactsfigures/breastcancerfactsfigures/breast-cancer-facts-and-figures-2011-2012

5American Cancer Society (ACS). (2013). Cancer facts & figures 2013. Accessed Jul. 30, 2013, from http://www.cancer.org/research/cancerfactsfigures/cancerfactsfigures/cancer-facts-figures-2013

6Chen, W.Y. (2013, Jul. - Last updated). Factors that modify breast cancer risk in women. Accessed Aug. 1, 2013 from http://www.uptodate.com/contents/factors-that-modify-breast-cancer-risk-in-women

7Chen, W.Y. (2013, Jan. - Last updated). Patient information: factors that modify breast cancer risk in women (Beyond the Basics). Accessed Aug. 7, 2013 from http://www.uptodate.com/contents/factors-that-modify-breast-cancer-risk-in-women-beyond-the-basics

8U.S. Preventive Services Task Force (USPSTF). (2009). Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med, 151:716-726.

9Saslow, D., Boetes, C., Burke, W., et al. (2007). American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin, 57(2):75-89.

10Smith, R.A., Saslow,  D., Sawyer, K.A., et al. (2003). American Cancer Society guidelines for breast cancer screening: update 2003. CA Cancer J Clin, 53(3):141-69.

 

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Last updated: August 25, 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

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