Breast Cancer in the United States
An estimated 178,480 new cases of invasive breast cancer are expected to be diagnosed in women in the United States during 2007.
• Approximately 1,000 Maine women will be diagnosed with breast cancer and approximately 200 will die from the disease.
• About 2,030 men in the United States will be diagnosed with breast cancer in 2007.
• Breast cancer is the most frequently diagnosed non-skin cancer in women.
• An estimated 40,910 breast cancer deaths (40,460 women and 450 men) are expected in 2007.
• Breast cancer ranks second among cancer deaths in women (after lung cancer).
Risk Factors
The risk of being diagnosed with breast cancer increases with age.
Important factors that increase a woman’s risk for developing breast cancer include certain inherited genetic mutations (BRCA1 and BRCA2), a personal or family history of breast cancer, high breast-tissue density as seen on mammograms, biopsy-confirmed hyperplasia, and high-dose radiation therapy to the chest.
Other risk factors include a long menstrual history, obesity after menopause, recent use of oral contraceptives, postmenopausal hormone therapy, never having children or having one’s first child after 30, or consumption of one or more alcoholic beverages per day.
Prevention
At this time, there is no guaranteed way to prevent breast cancer, which is why regular mammograms are so important. A woman’s best overall preventive health strategies, besides regular mammograms, are to: Maintain a healthy body weight; Engage in regular physical activity; Reduce alcohol consumption.
Other than these lifestyle changes, the most important action a woman can take is to follow the American Cancer Society’s early detection guidelines, which can help find breast cancer when the likelihood of successful treatment is greatest.
For women who have already been diagnosed with the disease, a Journal of the American Medical Association (JAMA) study found that exercise improves survival in women with breast cancer. The study found that women with breast cancer who engaged in an amount of physical activity equivalent to walking one or more hours per week had better survival compared with those who exercised less than that or not at all.
A Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center study found that women treated for breast cancer who followed a low-fat diet significantly reduced their chances of a recurrence. For a selected group of women with breast cancer who were post-menopausal and whose tumors were not hormonally sensitive, the study found that maintaining a low-fat diet may decrease the recurrence of breast cancers.
Early Detection
Studies show that early detection, when followed by appropriate treatment, saves lives and increases treatment options. The five-year survival rate for breast cancer is 98 percent among individuals whose cancer has not spread beyond the breast at the time of diagnosis.
Mammography is especially valuable as an early detection tool because it can identify breast cancer at an early stage, usually before physical symptoms develop.
American Cancer Society Recommended
Screening Guidelines
Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
A clinical breast exam should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women age 40 and older.
Women should know how their breasts normally look and feel and report any breast change promptly to their health care providers. Breast self-exam is an option for women starting in their 20s.
The American Cancer Society recommends that some women – because of family history, a genetic tendency, or certain other factors – be screened with MRI in addition to mammograms. (The number of women who fall into this category is less than 2 percent of all the women in the United States.) Women should talk with their doctor about their history and whether they should have an MRI. They may also call the American Cancer Society for more information about screening.
Treatment
Cancer treatment varies widely depending on the type and stage of cancer, as well as the age and medical history of the patient. Treatment for breast cancer may include surgery (i.e., lumpectomy or mastectomy), chemotherapy, radiation therapy, and/or hormone therapy.
Patients should discuss treatment options for the best management of their breast cancer with their health care providers. Treatment decisions are made by the patient and her physician after consideration of the optimal treatment available for the stage and biological characteristics of the cancer, the patient’s age and preferences, and the risks and benefits associated with each treatment protocol. Most women with breast cancer will have some type of surgery. Surgery is often combined with other treatments such as radiation therapy, chemotherapy, hormone therapy, and/or monoclonal antibody therapy. Treatment guidelines from the National Comprehensive Cancer Network (NCCN) are available through the American Cancer Society Web site at www.cancer.org.
One exciting area of progress is the development of treatments that target certain types of tumors. For example, the drug Herceptin has been successful in treating women with particularly aggressive breast tumors that have a specific genetic makeup. These tumors account for about 15 to 25 percent of all breast cancers. Herceptin has improved survival for many women with advanced and/or metastatic breast cancer. The most recent studies suggest that this treatment will also be successful for women with early-stage breast cancer.
Three drugs that stop estrogen production in postmenopausal women have been approved for use in treating both early and advanced breast cancer. These drugs (aromatase inhibitors) – letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin) – work by blocking an enzyme responsible for producing small amounts of estrogen in postmenopausal women. Many doctors prefer aromatase inhibitors over tamoxifen as the first hormonal treatment for postmenopausal women whose breast cancer has come back but only if the cancer is hormone receptor positive.
