|
|
Breast Health Fact Sheet
Facts about breast cancer:
- One in eight women will develop breast cancer in her lifetime.
- Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer.
- The chance that breast cancer will be responsible for a woman's death is about 1 in 35 (about 3 percent). In 2009, it is estimated that approximately about 40,170 women in the United States will die from breast cancer.
Younger women and unique breast health issues:
- Breast cancer is the leading cause of death for American women aged 35 to 50
- Women under 40 account for 6% of invasive breast cancers, or 11,000 new cases annually, which equals the total number of new cervical cancers. Women under 50 account for 20% of invasive breast cancers, or 36,000 new cases annually, which is more than the total number of new cervical and ovarian cancers combined.
(Ref. Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2004, National Cancer Institute. Bethesda, MD,)
- (Percentages aren’’t that impressive without a comparison to real numbers and relation to incidence of other diseases, so I would drop the next 2 bullets.)
- Young women tend to have biologically more aggressive tumors, translating into a more unfavorable prognosis.
Current Screening Guidelines
- The American Cancer Society Guidelines for the Early Detection of Breast Cancer in Average-Risk Asymptomatic Women are as follows:
- Ages 20-39: Clinical breast examination every three years and an optional monthly breast self examination
- Ages 40 and older: Annual mammogram, annual clinical breast examination and an optional monthly breast self examination
- Clinical experience has shown that none of these methods are effective in identifying cancers at the cellular level.
- By the time cancer is detected by either physical examination or mammography, a woman may have had the disease for six to ten years, with significant risk of serious consequences - including death.
Breast Cancer Risk Factors
- Eight out of nine women who develop breast cancer have no direct family history of the disease.
- Only 5 percent of new breast cancers can be attributed to hereditary syndromes.
- Other than being a woman, age is the most important risk factor for breast cancer. Additional risk factors that have been identified include hormones , a high-fat diet , smoking and alcohol intake .
- Family history of breast cancer (shouldn’t the first 2 bullets be grouped under this heading? And I would make family history the first bullet.)
- Women with a family history of breast cancer, especially if their mother, sister or daughter has the disease, have an increased risk of developing breast cancer. This risk is higher if more than one relative has developed breast cancer, and increases the younger the relative was at the time of diagnosis.
- Race
- Early menarche (onset of menstruation), late menopause, no children or first pregnancy after age 30
- Women with atypical cells in their breast ducts are 4 to 5 times more likely to develop breast cancer.
Refs: Wrensch MR, Petrakis NL, et al. Breast cancer incidence in women with abnormal cytology in nipple aspirates of breast fluid. Am J Epidemiol 1992;135(2):130-41.
Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. NEJM 1985;312(3):146-151
Fabian CJ, Kimler BF. Short-term breast cancer prediction by random periareolar fine-needle aspiration cytology and the Gail Risk Model. JNCI 2000; 92(15):1217-1227
Hartmann LC, Sellers TA, Frost MA, et al. Benign Breast Disease and the Risk of Breast Cancer. NEJM 2005;353(3):229-237
Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, Altekruse SF, Feuer EJ, Huang L, Mariotto A, Miller BA, Lewis DR, Eisner MP, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission, posted to the SEER web site, 2009
The American Cancer Society: Breast cancer key statistics. Available online at: http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_are_the_key_statistics_for_breast_cancer_5.asp
The American Cancer Society: Breast cancer key statistics. Available online at: http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_are_the_key_statistics_for_breast_cancer_5.asp
American Cancer Foundation, http://www.abcf.org/index.cfm?fuseaction=dsp&page=detection, Accessed March 21, 2007.
McKenney SA. The Role of the Nurse Practitioner in the Care of Young Women with Breast Cancer. <Breast Dis. 2009 Sep 3;23:115-121. [Epub ahead of print]
Bentz J. The role of nipple-aspirate fluid cytology in breast-cancer risk screening. MLO Med Lab Obs. 2009 Mar;41(3):8, 10, 12-7.
Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet. 2001 Oct 27;358(9291):1389-99.
Osteen R. Breast cancer. In: Lenhard RE, Osteen RT, Gansler T, eds. Clinical Oncology. Atlanta, GA: American Cancer Society; 2001:251-268.
Yager JD, Davidson NE. Estrogen carcinogenesis in breast cancer. N Engl J Med. 2006 Jan 19;354(3):270-82.
Chlebowski RT, Blackburn GL, Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study.J Natl Cancer Inst. 2006 Dec 20;98(24):1767-76.
Croghan IT, Pruthi S, Hays JT, Cha S, Johnson RE, Kosel M, Morris R, Hurt RD. The role of smoking in breast cancer development: an analysis of a Mayo Clinic cohort. Breast J. 2009 Sep-Oct;15(5):489-95. Epub 2009 Jul 13.
Boffetta P, Hashibe M, La Vecchia C, Zatonski W, Rehm J. The burden of cancer attributable to alcohol drinking.Int J Cancer. 2006 Aug 15;119(4):884-7.