The lifetime risk of breast cancer has increased during the 20th Century. In 1940, the risk to age 85 years was 1 in 20, about 5 percent. By 1989, the risk to age 85 years was about 1 in 9, about 11.1 percent. Today, the risk to age 85 years is about 1 in 8 or about 12.1 percent.
This is due to the long-term trend of increasing breast cancer incidence and increasing longevity. Life expectancy of women born between 1900 and 1902 was 51 years, compared to those born between 1959 and 1961 with a life expectancy of 74 years. The greatest rate of increase of most cancer incidence is in women 40 years of age and older. Lifetime risk represents the accumulation of risk over successive intervals with each interval having higher risk than the previous interval. For example, in the decade of your 20s, the 10 year risk is 1 in 1760. The risk rises to 1 in 229 in your 30s. Further, to 1 in 69 in your 40s and 1 in 42 in your 50s. In your 60s, the risk is 1 in 29 and in your 70s it is 1 in 27. Again, the lifetime estimated cumulative risk, (0 - 85 years), is 1 in 8. The peak incidence of breast cancer in a 2003 - 2007 study was 75 years of age.
The good news is that breast cancer death rate has fallen 38 percent since 1990 according to the 2014 data from the National Cancer Institute SEER database. This downward trend is credited to the increased use of screening mammography as organized since the early 1980s. This is further supported by new treatment and therapies. This means almost 275,000 breast cancer deaths have been averted since 1990. In 1990, 73.8 women per 100,000 died of breast cancer. This dropped to 45.9 per 100,000 in 2014.
Regular screening mammography can detect cancer early when it is most treatable and can be treated less invasively. This helps preserve quality of life.
The American Congress of Obstetricians and Gynecologists, American College of Radiology, and Society of Breast Imaging, (physicians with expertise in breast cancer care), continue to recommend that women start getting annual mammograms and clinical breast exams at age 40 years, continuing as long as one is healthy.
What are some risk factors for breast cancer?
- Being female. However, 2 percent of all breast cancers are in males.
- Older age. Persons 65 - 69 years of age have 17 times the risk of those 30 - 34 years of age.
- Those living in North America or Europe have 4 - 5 times the risk of those in Asia.
- History of mother or sister with breast cancer raises risk 2 - 3 times.
- Mammographically dense breasts, 2 - 4 times the risk.
- Obesity, 2 times the risk.
- Alcohol. 3 or more drinks per day increases risk 40 percent over non-drinkers.
- Hormone replacement therapies - variable risks judged individually.
- Additional risk factors can be addressed by regular check-ups with your healthcare provider and yearly mammography, where additional care and education can be obtained.
About the author
John Williams, MD, is a radiologist at Wes & Jan Houser Women’s Pavilion. Dr. Williams specializes in diagnostic radiology and has worked at Freeman Health System for more than 20 years. Wes & Jan Houser Women's Pavilion is accredited in breast MRI and designated a Breast Imaging Center of Excellence by the American College of Radiology (ACR). By awarding facilities the status of Breast Imaging Center of Excellence, the ACR recognizes breast imaging centers that have earned accreditation in mammography, stereotactic breast biopsy and breast ultrasound. For questions or to schedule an appointment, call 417.347.7777. Visit freemanhealth.com/womenspavilion for more information.