The source of information for this article is The American Cancer Society Breast Cancer Facts and Figures 2017-2018
In the US 12.4% of women, or 1 in 8, will get breast cancer in their lifetime. That also means that 87.6% of women will never get breast cancer. Remember that 12.4% number is a lifetime risk. Someone who is 50 years old only has a 2.3% chance of having breast cancer by the time they turn 60.
Good news: The risk of breast cancer has remained constant for about 10 years. Breast cancer survival is up. From 1989 to 2015 the chance of survival increased by 39%. That adds up to 322,600 lives saved in the US! This is likely due to improved treatment and early detection.
Unfortunately racial disparities still exist, but are improving. Mortality for non-hispanic whites is 19.7 out of 100,000 in NC and mortality for non-hispanic blacks is 29.1 out of 100,000 diagnosed.
Stage 1 survival rates are 99%. So, early detection is key!
Men can get breast cancer too. 1.3 in 100,000 men are diagnosed. It is important to be aware of that especially if there is a family history of breast cancer. Men tend to be diagnosed at a later stage because of a lack of awareness and lack of screening.
We can manage some risk. If we consider a 50 year old has a 10 year chance of breast cancer of 2.3% we can then calculate the risk based on risk factors. Being obese after menopause increases risk by 2 times, so that take that 10 year risk to 4.6%. Vigorous exercise can decrease risk by 20-30%, so down to a 1.6%. Daily alcohol consumption can increase risk 20-50%, even one drink a day. So that 2.3% risk becomes 2.76-3.45%.
There are also risks that we can’t change such as family history, age at menopause, age of first pregnancy, age of first period. Thankfully we have risk calculation models that can take many of these into account and provide a lifetime risk calculation for an individual that we can use to guide your decisions about screening and treatment.
Screening based on lifetime risk:
Women with a lifetime risk less than 15% may choose yearly mammograms and some may consider every two years, though I prefer yearly. Mammograms may start as early as age 35 and as late as 45 depending on risk.
Women with a lifetime risk of 15-20% should have yearly mammograms and may consider adding a yearly MRI.
When lifetime risk is over 20% a mammogram plus MRI is encouraged.
For women who carry genetic mutations and may have a risk over 70% preventive surgery is an option. Other options are risk-lowering medications and increased screening.
Studies of regular screening mammogram programs in Canada resulted in a decline in breast cancer death rates by 31-91 per 100,000 women. If you consider that Charlotte has about 200,000 women between age 40-80, the potential for life savings with mammogram has a big impact.