October is Breast Cancer Awareness Month

Facts About Breast Cancer

What You Should Know

• Of all cancers, breast cancer is the third most commonly diagnosed cancer in Michigan. It is the most frequently diagnosed cancer among Michigan women.
• Approximately one in eight women will develop breast cancer sometime during her lifetime.
• Early detection is the key to survival. With regular screening, breast cancer is more likely to be detected at an earlier stage, when it is most treatable. The five-year survival rate among women whose breast cancer has not spread beyond the breast at the time of diagnosis is 96 percent.
• The Michigan Department of Community Health, the American Cancer Society, and the American Medical Association recommend:
  • Women under 40 receive clinical breast exams by their health care providers every three years and perform breast self-exams every month.
  • Women 40 and older receive yearly mammograms and yearly clinical breast exams by their health care providers. They also should continue to perform monthly breast self-exams.

Risk Factors

• Although every woman is at risk of developing breast cancer, several factors have been shown to increase this risk. These include: increasing age; a personal history of breast cancer; a family history of breast cancer (especially pre-menopausal onset) in a mother, a sister, or other multiple relatives; never giving birth or having a first child after the age of 30; and a long menstrual history. Other possible risk factors that have been suggested include obesity, low physical activity, and alcohol consumption. 
• Approximately 5 percent to 10 percent of breast cancer is inherited, due to strong genetic factors. Most of these familial cases are due to mutations in either the BRCA-1 or BRCA-2 genes. The frequency of these genes varies among different ethnic backgrounds. Individuals who carry mutations in these genes also may be at an increased risk of developing other cancers.

Incidence and Mortality

• During 2002, 6,998 women in Michigan were newly diagnosed with breast cancer. 1. During 2003, 1,425 Michigan women died of the disease.  
• Mortality rates associated with breast cancer have decreased in Michigan from 3.5 deaths per 10,000 women in the late 1980's to 2.5 deaths per 10,000 women in 2003. These rates are similar to the national rates.
• The incidence and mortality associated with breast cancer vary by race. Although the incidence of breast cancer is highest among white women, breast cancer mortality rates are highest among racial minorities. African-Americans are 37 percent more likely than Caucasians to die from breast cancer, partly due to a later stage at diagnosis. However, even at the same stage of diagnosis, African-Americans women show lower survival rates.

Stage at Diagnosis

• Since the 1980s, there has been a dramatic trend toward earlier stage cancer at the first time of diagnosis. Breast cancer among Michigan women is increasingly being diagnosed at the local stage, before it has spread to other organs. 
• During 2002, 60.6 percent of all newly diagnosed cases of breast cancer were localized; in 1985, only 46.9 percent of cases were diagnosed at this stage.
• During 2002, 49.4 percent of newly diagnosed breast cancer cases in African-American women were localized, compared with 62.5 percent in Caucasian women.
• Older women are more likely than younger women to be diagnosed with breast cancer at the local stage. Among women below 40 years of age, 45.2 percent of newly diagnosed cases were localized; among women between 40 and 64, 59.1 percent were localized; and among women 65 and older, 64.1 percent were localized.

Screening Behaviors

• More than 93 percent of Michigan women 20 years old and older have received at least one clinical breast exam during their lifetime.
• More than 93 percent of Michigan women 40 years old and older have received at least one mammogram during their lifetime.
• Among Michigan women 40 years old and older, 44percent do not receive appropriately timed breast cancer screening (i.e., annual mammograms and clinical breast exams). Women less likely to receive appropriately timed screening include women with lower education levels, women with lower household incomes, uninsured women, women over 75, widows, and smokers.