Breast Cancer in the United States

Breast cancer is the most common type of cancer in women and the second leading cause of cancer-related deaths. In 2000, the American Cancer Society (ACS) estimates that approximately 182,800 new cases of invasive breast cancer will be diagnosed and that 40,800 women will die from this disease. Approximately one out of every eight women in the United States who lives to be 85 years or older will develop breast cancer during her lifetime.

However, women have a good chance of surviving breast cancer for many years when it is detected early. Nationwide, the 5-year relative survival rate for women diagnosed with in situ breast cancer is 97%, up from 78% in the 1940s. Early detection is essential in effective treatment of breast cancer: the 5-year survival rate drops to 78% for cancer diagnosed at a regional stage and as low as 22% for cancer diagnosed at a distant stage (ACS, 2000).

About 0.9% of breast cancer in the United States affects males. In 2000, 1400 new cases of breast cancer are expected to be diagnosed in men. Notable differences from women include older age at presentation and subareolar location. Diagnosis at advanced stages, rather than indicating a more aggressive disease than in women, is often a result of inattention and delay of diagnosis.

Incidence—Nationwide Trends: Breast cancer incidence increased more or less steadily between 1940 and 1987 and has since stabilized at 109.6 cases per 100,000 women. Non-Hispanic white women are more likely to develop breast cancer than African American women (or other ethnic groups such as Hispanic or American Indian women). Incidence rates increased more for older women than younger, and more for African American than for non-Hispanic white women. This increase and later stabilization of rates is believed to be related to increased use of breast cancer screening methods, particularly mammography.

Since the major risk factors for developing breast cancer (such as age, gender, and genetic susceptibility to cancer) are inherited or otherwise beyond women’s control, identifying and addressing factors which can lead to prevention and early stage diagnosis of breast cancer are essential to improving breast cancer survival and women’s health. Nationally, women over age 50, women who have low formal education levels, women of low socioeconomic status, and African American women are at particular risk for later stage breast cancer at diagnosis and have lower overall survival rates.

Mortality—Nationwide Trends: Mortality from breast cancer has been relatively stable since 1950 but since 1989 has declined 5.5% among non- Hispanic white women nationwide. However, mortality increased 2.6% for African American women during the same period. The recent decline in breast cancer mortality among non-Hispanic white women has been attributed in part to increases in breast cancer awareness and screening, leading to increased diagnosis of the disease at earlier stages (ACS, 2000).

• Breast cancer is the most frequently diagnosed cancer among women.
• In 2000, an estimated 182,800 women in the United States will be newly diagnosed with breast cancer, and an estimated 40,800 women will die of the disease.
• Breast cancer incidence and mortality patterns vary substantially among the major ethnic groups.
• There has been a trend over time toward diagnosis of smaller size tumors for all ethnic groups, probably due to early mammographic screening.

Download Breast Cancer in New Mexico: A Handbook

PDF format, 1MB, 74Pages.

Breast Cancer in New Mexico
A Handbook for Health Care Providers 2000

The revision of this handbook was sponsored by 
New Mexico Department of Health, Breast and
Cervical Cancer Detection and Control Program
with funds from the
Centers for Disease Control and Prevention.

This publication was prepared and edited by
Carla J. Herman, MD, MPH, Associate Professor,
Department of Internal Medicine,
University of New Mexico.

Contents:
Breast Cancer ........................................................... 1
Breast Cancer in the United States ....................................... 2
Risk Factors .......................................................................... 4
Breast Cancer in New Mexico ............................. 9
Breast Cancer and Ethnicity ............................................... 12
Non-Hispanic White Women ....................................... 12
Hispanic Women .......................................................... 13
American Indian Women .............................................. 14
Older Women and Men ................................................ 15
Screening Practices ............................................................. 18
Breast Cancer Screening .................................... 21
Screening Guidelines .......................................................... 22
Breast Self-Examination ..................................................... 23
Clinical Breast Examination ............................................... 26
Mammograms .................................................................... 31
Future Considerations ........................................................ 39
Diagnosis and Referral ...................................... 41
Management of Palpable Masses ........................................ 42
Management of Non-Palpable Masses ................................ 45
Special Considerations ....................................................... 46
Resources for Information and Referral.................. 47
Support Groups and Health Care Information Services ...... 48
Additional National and State Resources ............................ 53
Professional Education ....................................................... 55
Electronic Resource Directory ............................................ 56
Patient Education Pages ..................................................... 57

The Breast Self-Exam Step-by-Step

Check your breasts at the same time of each month.

The best time is 2–3 days after your period ends. If you are not having periods, pick a day in the month, like the first day of the month, to examine your breasts.

1 Looking in the mirror for changes

Take off your shirt and bra and stand in front of a mirror with your arms at your side. Look for wetness from your nipples and for skin on your breasts which looks wrinkled or flaky.

Hold your hands behind your head and press your hands forward. Look for any change in the shape of your breasts.

Press your hands firmly on your hips. Bend a little forward and pull your shoulders and elbows forward. Look for any changes in the shape of your breasts.

2 Feeling for lumps

Raise your left arm. Use three or four fingers to feel your breast firmly. Begin at the outer part of the breast. Press on your breast with the flat part of your fingers and move in small circles. Move around the entire breast, working toward the nipple. Be sure to feel the whole breast. Feel the area between the breast and underarm and also under your arm. Raise your right arm and do the same with the right breast and underarm.

Lie down flat on your back with your left arm over your head. Put a pillow or folded towel under your left shoulder. Feel your breast and underarm the same way you did when you were standing. Do the same with your right breast and underarm.

3 Checking for nipple discharge

Gently squeeze each nipple to see if anything comes out.

If you notice a lump, swelling, dimpling, nipple tenderness, nipple discharge, or lasting pain, contact a health care provider immediately.

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