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Breast Cancer


Minority women are most likely to have advanced breast cancer when the cancer is first discovered. Although white women are more likely to get breast cancer, African American women are the most likely to die from it.



What is Breast Cancer?

Breast cancer is extremely common among women. It’s main causation factor is genetic mutation of the BRCA1 and BRCA2 genes, but there are others suspected to be involved as well. The second major factor is age as the rates of incidence rise significantly with age. It is usually caught and diagnosed while still localized in an early stage. This is partly due to the fact that it is well-screened, and once women reach their 40s it is advised to get a mammogram every two years to check for signs of cancer. Screenings also allow pre-cancerous cells to be identified and treated.


Breast Cancer Treatment


Treatment in early stages is often very effective. One type of treatment is surgical removal of malignant tissue (lumpectomy) or of the affected breast altogether (mastectomy). Chemotherapy and radiation are also common treatments. Often, treatment plans for more patients with more developed or extremely aggressive cases will include more than one method of treatment. One common issue is that women who are determined to need mastectomies often delay making the decision to go through with surgery or opt for riskier alternatives. For those who opt for non-surgical alternatives in such a situation, there is a higher chance of the disease recurring. Whichever path a patient chooses, deciding on and proceeding with a treatment quickly gives the best odds of success.


Can Men Have Breast Cancer?


Men represent less than 1% of the patient population for breast cancer while about 1 in 8 women will contract the disease in the US with a 5-year survival rate of over 99%. Even though the chances of getting breast cancer almost double if there is a family history of it, the vast majority (over 85%) of women afflicted have no family history. Black women have a higher mortality rate while asian and native americans have a lower risk. Ashkenazi Jews have a higher risk of contracting the disease due to higher mutation rates of the BRCA genes.





QUICK FACTS

  • In 2021, an estimated 281,550 new cases of invasive breast cancer will be diagnosed in women in the U.S. as well as 49,290 new cases of non-invasive (in situ) breast cancer.

  • 63% of breast cancer cases are diagnosed at a localized stage, for which the 5-year survival rate is 99%. At this stage, there is no sign that the cancer has spread outside of the breast.

  • This year, an estimated 43,600 women will die from breast cancer in the United States alone.

  • Although rare, men can also be diagnosed with breast cancer. In 2021, an estimated 2,650 men will be diagnosed with breast cancer this year in the U.S. and approximately 530 will die.

  • 1 in 8 women in the United States will be diagnosed with breast cancer in their lifetime.

  • Aside from skin cancers, breast cancer is the most common cancer in American women. It is estimated that in 2021, approximately 30% of all women’s cancer diagnoses will be breast cancer.

  • There are over 3.8 million breast cancer survivors in the United States.

  • On average, a woman is diagnosed with breast cancer in the United States every 2 minutes.


Breast Cancer Risk Factors




  • Lifetime Risk

  • Known Risk Factors that affect everyone

    • AFAB and getting older

  • Known Risk factors that vary by race / ethnicity[1]

    • Age at first menstruation

    • Age at menopause

    • Age at first childbirth

    • Body weight

    • Breastfeeding

    • Number of children

    • Menopausal hormone therapy (postmenopausal hormone use, hormone replacement therapy)

Breast Cancer Symptoms

Most Common:

  • A change in the look or feel of the breast OR

  • A change in the look or feel of the nipple OR

  • Nipple discharge


Possible signs:

  • Lumps or thickening in breast or underarm area

  • Changes in color to the overlying skin

  • Changes in size – differences between breasts

  • Dimpling or puckering of skin

  • Itchiness, scaliness, rash

  • Pulling of nipple inwards

  • New pain in one spot









Breast Cancer Screening




Breast Cancer Screening Disparities

Lack of health insurance is main reason for breast cancer screening disparities in US

  • Without insurance, only 39% get mammo in past 2 years

  • But even among women with insurance, only 75% had a recent mammo

  • Hispanic/Latina women have similar mammo rates, but may have higher number of barriers to screening and follow-up11


Barriers:


  • Worry about the cost out of pocket

  • Lack of access (no local mammo center, lack of transportation)

  • Lack of primary care provider to get referral

  • Low health education about screening importance

  • Limited understanding of breast cancer risks

  • Lack of sick leave/unable to miss work

  • Lack of child care

  • Fear of bad news from the screening tests

  • Recent migration to the US

  • Cultural and language differences

  • Low level of trust in health care providers


Breast Cancer Diagnosis Factors

  • Delays in follow-up care for Black and African American women after an abnormal mammo may play a role in survival rate differences

  • Tumor Biology may play a role as well

    • Black and African American women more likely than white women to be diagnosed with triple negative breast cancer, an aggressive type of breast cancer

  • Age at diagnosis

    • Black women tend to be diagnosed at a younger age. Median age is 60 in Black women compared to 64 for white women

  • Hispanic or Latina women tend to be diagnosed with more advanced breast cancers than white women, possibly due to delays in follow-up12

  • American Indian and Alaska Native women: lower rates of breast cancer screening, possibly due to access of care13

  • Asian American, Native Hawaiian, Pacific Islander women in the US have lower rates of breast cancer screening and delays in aftercare.


Treatment

Treatment options for Breast Cancer include Radiation, Chemo, Surgery, Hormone therapy, HER2-targeted surgery, Immunotherapy




A Lumpectomy is a surgery to remove cancer from the breast. Unlike mastectomy, lumpectomy removes only the tumor and a small rim of normal tissue around it. It leaves most of the breast skin and tissue in place.


With lumpectomy, the breast looks as close as possible to how it did before surgery. Most often, the general shape of the breast and the nipple area are preserved.


Lumpectomy is also called breast-conserving surgery, partial mastectomy and wide excision.


A Mastectomy is the surgical removal of the entire breast.


Some women have the option of mastectomy or lumpectomy (also called breast-conserving surgery) plus radiation therapy, and choose mastectomy. For other women, mastectomy is the only breast cancer surgery option.


Breast Cancer Resources:

Resources for Established and Probable Risk Factors:

Resources for Risk Factors Under Study:

Resources for Risk Factors Not Related to Breast Cancer:

Risk-Lowering Drugs (Chemoprevention)

Early Detection and Screening

Breast MRI

Diagnosis and Prognostic Factors



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