Breast Cancer • background Facts and figures

Breast cancer is the most common cancer among women, other than skin cancer. About two million breast cancer survivors are alive in America today.

In 2002, there will be about 202,800 new cases of female invasive breast cancer diagnosed, and about 45,800 women will die from the disease. Nearly 46,000 cases of female in situ (pre-invasive) breast cancer will be diagnosed in 2002. Breast cancer is the second leading cause of cancer death for all women (after lung cancer), and the leading cause of death in women between the ages of 40 and 55.

Men can develop breast cancer, too, although its incidence is low. In 2000, about 1,400 male cases are projected to be diagnosed, and 400 men will die from the disease.

One out of eight women in the United States will develop breast cancer in her lifetime,  a risk that was one out of 14 in 1960. This year, a breast cancer will be newly diagnosed every three minutes, and a woman will die from breast cancer every 13 minutes. The chance of getting breast cancer goes up as a woman gets older. The National Cancer Institute (NCI) has given the following statistics of a woman's chances of developing breast cancer:

Every woman is at risk for breast cancer. This risk of developing breast cancer increases as a woman ages, if she has a family history or personal history of breast cancer, has never had children or had her first child after age 30, early onset of menstruation (before age 12), late menopause (after age 55), exposure to radiation, diet high in fat, being overweight (for older women only). However, over 70 percent of cases occur in women who have no identifiable risk factors.

Breast cancer cannot yet be prevented. However, there is now a risk reduction option available for women at very high risk, such as the estimated five to ten percent of American women with multiple close blood relatives who have had the disease. In 1998, the drug tamoxifen was shown to reduce breast cancer cases by 50 percent over four years in a large research study of high-risk women. Tamoxifen is FDA-approved for use in this high-risk group, however, the drug's benefits, risks and side effects vary for each woman, and must be thoroughly discussed with an expert physician.

Fewer than a third of American women follow recommended guidelines for screening mammography, a simple procedure that can reveal small breast cancer up to two years before lumps can be felt. Mammography is the single most effective method of early detection. However, it is not perfect. Screening mammograms can miss up to 25 percent of breast cancers in women in their forties compared with about 10 percent of cancers for older women. There are several factors that play a role in the sensitivity of mammography (the ability to detect breast cancer when cancer is present), i.e. lesion size, lesion conspicuity, breast tissue density (the dense breasts of younger women contain many glands and ligaments, which make breast cancers more difficult to spot in mammograms), patient age and hormone status, overall image quality, and interpretive skill of the radiologist. This is why annual breast exams by a medical professional and monthly breast self-examinations are required compliments.

Only 20-30% of women are doing monthly breast self-exams, even though statistics report that most breast irregularities are found by women themselves or significant other. This is why it is so important to learn how to perform breast self-examination and incorporate it into your monthly routine, one week after your menstrual cycle begins.

Report any changes found to your doctor for proper evaluation. Over 80 percent of  breast abnormality biopsies are proven benign, but any breast lump must be evaluated by a physician. New, less invasive biopsy procedures (such as stereotactic core needle biopsy) permit removal and evaluation of breast tissue in a surgeon's or radiologist's office, and require no special preparation or recovery period.

If detected early, breast cancer can often be treated effectively with surgery that preserves the breast, followed by radiation therapy. This local therapy is frequently accompanied by systemic chemotherapy and/or hormonal therapy. Currently, 62 percent of breast cancers are discovered at an early, "localized" stage, and five-year survival after treatment for early-stage breast cancer is 96 percent.

Myths and Facts about the Risk of Developing Breast Cancer

Myth: Breast cancer is preventable.
Fact: There is no known way to prevent breast cancer, and the cause of the disease has not been determined. Early detection followed by prompt treatment offers the best chance to treat breast cancer successfully.

Myth: Only women with known "risk factors" get breast cancer.
Fact: Over 70 percent of women diagnosed with breast cancer have no identifiable "risk factors." All women are at risk, and risk increases with age.

Myth: Only women with a family history of breast cancer are at risk.
Fact: The majority of women with breast cancer have no family history of the disease. A woman whose mother, sister, daughter or grandmother had breast cancer has an increased risk of developing the disease. These women should be screened earlier and possibly more often.

Myth: Breast cancer is contagious.
Fact: Cancer is not a communicable disease. It results from uncontrolled growth of cells in a person's own body. These changes cannot affect other people's cells.

Myth: Small breasted women cannot get breast cancer.
Fact: The amount of breast tissue a woman has does not affect her risk of developing breast cancer.

Myth: Breast-feeding causes/protects against breast cancer.
Fact: No studies have shown that breast feeding causes breast cancer. Some studies have even suggested that breast feeding may reduce a woman's risk of developing the disease. However, studies are ongoing on this topic.. A woman who breast feeds her children can still get breast cancer.

Myth: Only white women get breast cancer.
Fact: Every woman is at risk for breast cancer, regardless of race or socioeconomic status. African-American women have a higher mortality rate from breast cancer than white women. Breast cancer is the second leading cause of cancer death for African-American women.

Myth: Knowing you have the BRCA1 gene means you can prevent breast cancer.
Fact: Nothing can prevent breast cancer. About five percent of women in the United States who have had breast cancer are thought to carry the mutant BRCA1 gene. Women who carry this gene have an 85 percent lifetime risk of developing breast cancer. Once they are identified, they will need to be closely monitored by their doctors.

Myth: Prophylactic mastectomies protect against breast cancer in high risk women.
Fact: In a prophylactic mastectomy the surgeon removes breasts with no cancer, however, some of a woman's breast tissue remains. Breast tissue extends up towards the neck, the armpits, and the chest wall. Risk of developing breast cancer remains as long as there is breast tissue in the body.

Myth: A diagnosis of LCIS means you will definitely develop breast cancer.
Fact: Women with lobular carcinoma in-situ (LCIS) have an up to 30 percent risk of developing breast cancer in either breast over 30 years. Prophylactic mastectomy does not prevent the development of breast cancer. Women with LCIS should be monitored with frequent breast exams by their doctor and have yearly mammograms.

Myths and Facts about Breast Cancer Follow-Up Care and Survival

Myth: A diagnosis of breast cancer is a death sentence.
Fact: No! More than 2.0 million women who have had breast cancer are alive in the United States today. Most are living full lives, having careers, raising their families and even starting families. More than 90 percent of women who find and treat their breast cancer early are cancer free at five years.

Myth: Breast cancer is curable.
Fact: A breast cancer survivor always lives with the possibility of recurrence. Data has shown that breast cancer can recur as long as twenty years after diagnosis. For this reason, survivors should continue to have regular mammograms and see their doctors for regular check-ups.

Myth: Breast reconstruction can only be performed at the time of mastectomy.
Fact: Breast reconstruction can be done at the same time as mastectomy or in the future. It is up to the woman to decide which she would prefer. However, if she decides to consider reconstruction at a later time, she should discuss this with her surgeon before her mastectomy.

Myth: Saline implants are a completely safe alternative to silicone implants.
Fact: Saline implants are currently under study to determine their safety and effectiveness. All women who choose saline implants should enroll in a clinical trial to ensure they are closely monitored. At this point, no large clinical study has shown with certainty that there is a silicone/disease link.

Myth: Lymphadema is a likely side-effect of breast cancer surgery and treatment.
Fact: Lymphadema (swelling of the arm) is a possible side effect of axillary dissection and/or radiotherapy. It is often preventable by following some simple guidelines such as avoiding injections or taking blood pressure in the affected limb and refraining from heavy lifting and repetitive movements. For women affected there are a number of different therapies available to help relieve the discomfort associated with this condition. No good information exists about how frequently breast cancer patients experience lyphadema.

Myth: The more lymph nodes removed, the more impaired you will be.
Fact: Most surgeons perform "Level One" axillary dissections, which involves removing a pad of tissue and lymph nodes under the arm. The number of nodes in this pad differs from woman to woman. The number of nodes examined is generally at least ten, and does not affect a woman's recovery. If a more extensive dissection is performed, a woman's risk for side effects is increased.

Myth: A breast cancer diagnosis means your intimate relationships are in jeopardy.
Fact: Pleasurable intimate experiences between a woman and her partner are always possible, regardless of physical problems or medical history. Sexuality is an important part of everyday life, and this does not change with a diagnosis of breast cancer. Open communication with your partner about your relationship is very important. A woman should not hesitate to discuss the topic of sexuality with her doctor or other member of the health care team.

Myth: Women diagnosed with breast cancer can never have children.
Fact: Chemotherapy sometimes, not always, causes infertility in pre-menopausal women. Fertility in women who do not have chemotherapy is unaffected by breast cancer. Doctors generally recommend that women wait at least two to three years after initial diagnosis to become pregnant, because the risk of recurrence is greatest then.