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. Although mortality rates have steadily decreased since 1990, breast cancer remains the second leading cause of cancer deaths in U.S. women, exceeded only by lung cancer.¹

Key Statistics:

• In 2012, an estimated 226,870 new cases of invasive breast cancer will be diagnosed in U.S. women. In addition to invasive breast cancer, 63,300 new cases of carcinoma in situ (CIS) will be diagnosed.¹

• In 2012, an estimated 39,510 U.S. women will die from breast cancer.¹

• 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.²

• Although incidence is highest for Caucasian women, African Americans have the highest mortality rate from breast cancer (as explained by a more advanced stage at diagnosis and higher stage-specific mortality).³ Caucasian women have the second highest mortality rate, followed by American Indian/Alaska Native, Hispanic/Latino, and Asian American/ Pacific Islanders.⁴

• The overall mortality rate for women of all races combined from breast cancer has decreased since 1990, with larger decreases in women younger than 50. The decline is attributed to earlier detection and improved treatments.⁴
   
• When detected early, 5-year relative survival for localized breast cancer is 99%. For regional disease, it is 84%. If the cancer has spread to distant organs, 5-year survival drops to 23%. Larger tumor size at diagnosis is also associated with decreased survival.⁴

• As of January 2008, there were an estimated 2.6 million breast cancer survivors living in the U.S. More than half were diagnosed less than 10 years earlier.⁵

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.¹
   
• Age: As women age, the risk of developing breast cancer increases. About 66% of all invasive breast cancers are diagnosed in women age 55 or older, while about 12% are diagnosed in women younger than 45.¹  At age 75 to 80, risk stabilizes, decreasing slightly thereafter.³

• Family history of breast cancer: Risk is increased for women whose close relatives have the disease. About 15% to 20% of women with breast cancer report a positive family history in a first degree relative.³ In general, the more biological relatives with breast cancer, especially relatives diagnosed before age 50, the higher a woman's risk.¹

• Genetic factors: 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 women of Ashkenazi Jewish heritage, but they can occur in any racial or ethnic group.¹

• 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.¹

• Personal history of breast cancer: A history of breast cancer in one breast increases the risk of developing cancer in the other breast. With in situ cancer, the 10-year risk of developing a contralateral invasive breast cancer is 5%. With invasive breast cancer, the risk is 0.5% to 1% per year, depending upon a woman's menopausal status.³

• Dense breasts: Women whose mammograms show a large area of dense breast tissue (usually defined as equal to or greater than 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.¹

• 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 55.¹

• Hormone Replacement Therapy (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, 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.¹

• Radiation therapy to the chest when young: Risk is strongly increased for women treated with radiation to the chest for another cancer before age 30. The risk is highest for those treated during adolescence.¹ The most vulnerable ages appear to be between ages 10 to 14.³

• Being overweight: Excess weight, especially after menopause, has been shown to increase breast cancer risk by raising estrogen levels.^1, 3

• 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.¹

• Height: Height has been associated with a greater 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.³

• Other factors: Exposure to certain environmental substances and conditions may also increase a woman's risk of developing breast cancer.¹ Currently there is conflicting evidence regarding the risk of environmental exposure to organochlorines (weak estrogen compounds), and digitalis compounds, 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.³

Risk Reduction:   

• For women at average risk, the emphasis is on regular screening and healthy lifestyle habits, such as regular physical exercise and a healthy diet. Breast feeding has also been shown to reduce a woman's risk, especially if the breast-feeding lasts 1½ to 2 years.¹

• Women at increased risk are advised to consider additional risk reduction strategies in consultation with their health care providers.

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.⁶

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.^7, 8

For additional information on breast cancer screening and diagnosis, please visit:

• Breast Cancer Detailed Guide (American Cancer Society)
• What You Need to Know About Breast Cancer (National Cancer Institute)

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:

¹American Cancer Society (ACS). (2012). Breast cancer: detailed guide. Accessed Jul. 14, 2012, from http://www.cancer.org/Cancer/BreastCancer/DetailedGuide

²U.S. Department of Health and Human Services (USDHHS). (2008, Aug.). Preventing chronic diseases: Investing wisely in health - Screening to prevent cancer deaths. Accessed Jul. 14, 2012, from http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/cancer.pdf

³Costanza, M.E., Chen, W.Y. (2012, Jan.). Epidemiology and risk factors for breast cancer. Accessed Jul. 26, 2012 from http://www.uptodate.com/contents/epidemiology-and-risk-factors-for-breast-cancer?source=search_result&search=breast+cancer+risk+factors&selectedTitle=1~55

⁴American Cancer Society (ACS). (2011). Breast cancer facts & figures 2011-2012. Accessed Jul. 14, 2012, from http://www.cancer.org/Research/CancerFactsFigures/BreastCancerFactsFigures/breast-cancer-facts-and-figures-2011-2012

⁵National Cancer Institute (NCI). (2009). What you need to know about breast cancer. Accessed Jul. 25, 2011, from http://www.cancer.gov/cancertopics/wyntk/breast

⁶U.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.

⁷Saslow, 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.

⁸Smith, 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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Updated: November 28, 2012

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