Who Gets Breast Cancer
How does breast cancer affect...
- African Americans
- Ashkenazi Jewish Women
- Asian Americans
- Native Americans
- Transgender People
- Older Women
- Younger Women
- Pregnant Women
Breast cancer is the most common cancer among African American women. It is also the second leading cause of cancer death among African American women, exceeded only by lung cancer. In 2009, an estimated 19,540 new cases of breast cancer and 6,020 deaths were expected to occur among African American women . Although breast cancer incidence is lower among African American women, they have a 38 percent higher breast cancer death rate than Caucasian women . Breast cancer survival in African American women has increased in recent decades. However, survival rates among African American women remain lower than among Caucasian women. From 1999-2005 the five-year survival rate for breast cancer among African-American women was 79 percent compared to 91 percent among Caucasian women . There are many possible reasons for this difference in survival. Biologic and genetic differences in tumors, the presence of risk factors, barriers to health care access, health behaviors and later stage of disease at diagnosis may all play a role. It is important to know that mammography increases the chance that breast cancer will be found at the earliest, most treatable stages. Annual mammography screening and effective treatment offer the best chance for decreasing mortality and improving survival. For more on African American ethnicity and breast cancer, visit the Risk Factors and Preventionand Early Detection and Screening sections.
All women are at risk for breast cancer. However, some groups of women are at a higher risk for getting breast cancer. Breast and ovarian cancer are somewhat more common among women of Ashkenazi Jewish descent (ancestors who came from Central or Eastern Europe). Scientists have identified two specific genes that, when mutated, are important in the development of breast cancer. These genes are called Breast Cancer 1 and Breast Cancer 2 (BRCA1 and BRCA2, respectively).
Every woman has these genes, but women who have inherited a mutated form of one or both genes are at higher risk for breast and ovarian cancer. While BRCA mutations are very rare in the general population, an estimated 1 in 40 Ashkenazi Jewish persons, regardless of family history, carries one of these mutations [7-9]. Among the Ashkenazi population, three BRCA mutations are most common (185delAG, 5382insC in BRCA1 and 6174delT inBRCA2). If you are interested in genetic testing, talk with your health care provider. He/she can refer you to a genetic counselor. For information on genetic counseling, contact theNational Cancer Institute or the National Society of Genetic Counselors.
Among Asian American and Pacific Islander women, 2010 estimated breast cancer incidence (81.6 per 100,000) and mortality rates (12.5 per 100,000) are lower than those for non-Hispanic white and African American women . Breast cancer is the leading cancer among Chinese (77.6 per 100,000), Filipino (100.4 per 100,000), Japanese (126.5 per 100,000) and Korean (53.5 per 100,000) women . Native Hawaiian (175.8 per 100,000) and Samoan (102.5 per 100,000) women have the highest rates, which even exceed those in Caucasian women . Breast cancer is one of the leading causes of cancer death in most Asian American and Pacific Islander women (lung cancer is the major cause of cancer death among most of these women). Mammography screening rates remain slightly lower among Asian American and Pacific Islander women compared to non-Hispanic white women. However, most of this difference appears to be due to differences in socioeconomic status. Among women of similar socioeconomic status, rates are similar . For Asian Americans, new immigrants have a lower incidence of breast cancer than those who have lived in the U.S. for many years. And for those born in the U.S., breast cancer risk is similar to that of non-Hispanic white women (60 percent higher than women born in Asia) .
Breast cancer is the most common cancer among Hispanic/Latina women. In 2010, estimated incidence is 90.2 per 100,000 Hispanic/Latina women) and estimated mortality is 15.5 per 100,000 women . Hispanic/Latina women have lower breast cancer incidence and mortality rates compared to non-Hispanic/Latina White women. However, they are less likely to have regular screening mammograms and to get prompt follow-up for an abnormal mammogram . These differences may explain why they are more likely to be diagnosed at later stages of breast cancer. Many factors play a role in lower rates of screening mammograms among Hispanic/Latina women. These include lower income, lower levels of education, less access to health care, lack of health insurance, lack of awareness of breast cancer risks and screening methods as well as cultural and language barriers .
|Lesbian, Gay, Bisexual and Transgender|
Lesbians and women who partner with women have a greater risk of breast cancer than other women, but this is not because of their sexual orientation. Rather, it is linked to other risk factors (such as never having children or having them later in life) that are more common in these women [14-15]. They may also have higher rates of obesity and alcohol use, both of which can increase breast cancer risk [14-15]. And, lesbian women may also be less likely to get routine mammograms and clinical breast exams [16-17]. The reasons for this are not yet clear. However, lack of insurance, a perceived low level of breast cancer risk and not seeing a health care provider on a regular basis may all play a role [14-15]. For many women, reproductive health issues are their main link to the health care system. Even when seeing a provider about reproductive health, other health issues are often addressed, including having clinical breast exams or mammograms. But because fewer lesbians have children and therefore, do not seek routine health care, they may have fewer opportunities to have these screening tests for breast cancer. As a result, breast cancer may not be found as early as possible, when it is most treatable. One step lesbians can take is to find a provider who is sensitive to their health issues, and to see that provider on a regular basis—especially for clinical breast exams and mammograms.
|Lesbian, Gay, Bisexual and Transgender|
Data on breast cancer among transgender men and women are too limited to comment on any increase or decrease in risk in these populations at this time. If you are transgender, talk to your health care provider about your breast cancer risk. Your provider can assess your situation.
A century ago, breast cancer in Native Americans was rare. However, the last two decades have seen major increases in both incidence and mortality rates. In 2010, incidence is estimated to be 67.2 per 100,000 and mortality is estimated to 17.6 per 100,000 . Both incidence and mortality rates vary according to where women live. Women who live in Alaska have the highest incidence rates (similar to non-Hispanic white women) and women who live in the Southwest have the lowest incidence rates .
All women are at risk for breast cancer. The two most important risk factors for breast cancer are being female and getting older. The risk of getting breast cancer increases as you age. Most breast cancers and breast cancer deaths occur in women aged 50 and older. Until more is known about preventing breast cancer, early detection and effective treatment offer the best defense against breast cancer mortality.
Although rare, younger women can also get breast cancer. Just five percent of all breast cancers occur in women under age 40 . Women who are diagnosed with breast cancer at younger ages may have a BRCA1 or BRCA2 genetic mutation. These genes are important in the development of breast cancer. Women who carry defects on either of these genes are at greater risk of breast and ovarian cancer. For BRCA1 carriers, the chance of getting breast cancer ranges from 60 to 90 percent. And for BRCA2 carriers, estimates range from 30 to 85 percent [20-24]. So while the risk of breast cancer is generally much lower for younger women, there is still a high risk for some.
It is important for younger women to become familiar with how their breasts look and feel. Any change from normal should be checked out by a health care provider right away.
Breast cancer is the most common cancer in pregnant and postpartum women. It occurs in about 1 in 3,000 pregnancies . It may be harder to find a lump in pregnant and lactating women because their breasts are naturally more tender and enlarged. For more information about breast cancer during pregnancy, see the Treatment During Pregnancy section.
Breast cancer in men is rare, but it does happen. In 2010, about 1,970 men will be diagnosed with breast cancer, and 390 will die from it . Signs and symptoms of breast cancer in men include: nipple discharge (usually bloody), an inverted nipple, a breast lump, and sometimes, local pain, itching and pulling sensation. The survival rate of men is about the same as for women with the same stage of cancer at the time of diagnosis. However, men are usually diagnosed at a later stage because they are less likely to report symptoms. Treatment for men is the same as treatment for women and usually includes a combination of surgery, radiation, chemotherapy and/or hormone therapy.