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
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:
1 in 19,608
1 in 24
1 in 2,525
1 in 17
1 in 622
1 in 14
1 in 217
1 in 11
1 in 93
1 in 10
1 in 50
1 in 9
1 in 33
1 in 8
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
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
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
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
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
Myths and Facts about Breast
Cancer Follow-Up Care and Survival
Myth: A diagnosis of breast cancer is a death
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
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