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
- 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
is 98%. For regional disease,
it is 84%. If the cancer has spread
to distant organs, 5-year
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
- 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
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
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,
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
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
(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
cancer with mammography.2
- Reproductive history: Certain reproductive
factors slightly increase risk. These include
giving birth to a first child after
30, nulliparity (never having children),
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
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
as children or young adults (as with Hodgkin's lymphoma).
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
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
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.9, 10
of USPSTF and 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
|| 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.
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.
on cancer screening services for medically underserved
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
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 -
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.
Institute (NCI). (2012, Sep. - Last reviewed). Breast cancer risk in American women. Accessed Jul. 30, 2013,
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).
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
Services Task Force (USPSTF). (2009). Screening
for breast cancer: U.S. preventive services task
Intern Med, 151:716-726.
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,
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