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Facts:

• During 1998, an estimated 4,000 women in Indiana will have been diagnosed with breast cancer.
• The incidence rate for female breast cancer in the United States is 110.9 cases for every 100,000 women (1991-1995, age-adjusted). The incidence rate among white women (114.5) is significantly higher than that among African-American women (101.0).
• Since 1990, the incidence rate for female breast cancer has leveled off.
• The mortality rate for female patients with breast cancer in the United States was 26.0 deaths for every 100,000 women (1991-1995, age-adjusted and standardized). The mortality rate among African-American women (31.5) was significantly higher than that among white women (25.7).
• Nine hundred and eighty-six (986) Indiana women died from breast cancer in 1995. Between 1991-1995, Indiana's breast cancer death rate was 25.6/100,000.
• After increasing 0.2% per year from 1973 to 1990, breast cancer death rates decreased 1.7% per year from 1990 to 1995. This decrease was confined to white and Hispanic women, each having a 1.9% per year decrease in death rates from 1990 to 1995.

Who is at Risk?

• As women age, the risk of developing breast cancer rises significantly.
• Women over the age of 65 are twice as likely to develop breast cancer as women between the ages of 40-64.
• A woman is at greater risk for developing breast cancer if her mother, daughter, or sister develops the disease, especially if the relative acquired the disease at a young age.
• Women with no children, or those who had their first child after the age of 30, have an increased risk of developing breast cancer.
• Women who began menstruating before the age of 12 have an increased risk of developing breast cancer.
• Women who experienced menopause at a late age (average age of onset is 51) have an increased risk of developing breast cancer.
• When compared to white women, African-American women have a lower incidence (101.0 vs 114.5 per 100,000), yet a higher mortality rate (31.3 vs 25.8 per 100,000 women).
• African-American and Hispanic women are less likely than white women to receive screening for common types of cancer screening, such as breast exams and mammograms. This relates to the decreased incidence, yet increased mortality, rates of cancer among African-American women.
• Racial and ethnic differences in mortality may be related to the availability of preventive care and access to treatment.
• Breast cancer is diagnosed more frequently at a localized stage in whites than in AfricanAmericans; early detection and timely treatment could increase survival.

Figure 4. Breast Cancer Incidence Rates for White and African-American Women, 1991-1995.

Source: SEER Cancer Statistics Review, 1973-1995, National Cancer Institute

Warning Signs

• A lump or thickening in the breast or under the arm
• A change in the size or shape of the skin on the breast or nipple
• Change in the color or feel of the skin on the breast or nipple (i.e., redness, scaliness, dimpling, or puckering)
• Nipple discharge, pain or tenderness

Figure 5. Breast Cancer Mortality Rates for White and African-American Women, 1991-1995.

Source: CDC Wonder, http://wonder.cdc.gov/, August 1998

Actions to Decrease the Risk of Breast Cancer

1. Educate women regarding early detection. Recommended American Cancer Society precautions include:
2. AGE 20-39: monthly breast self-exam and annual clinical breast exam AGE 40-49: mammogram every 1-2 years, monthly self breast exams, and annual clinical breast exam AGE 50 and over: routine mammography screening, annual clinical breast exams and monthly breast self-exams.
3. Teach women about healthy lifestyles, how to perform self-exams and where to go for other screening and clinical exams.
4. Encourage women to adjust diet, exercise and any other behaviors that might put them at risk.
5. Teach women about treatment options and how to prevent lymphedema.

Healthy People 2000 Target/Indiana's Progress

• Reduce breast cancer deaths to no more than 20.6 per 100,000 women.
• Increase to at least 80% the proportion of women over the age of 40 who have received a clinical breast examination and a mammogram, and to at least 60% those over age 50 who have received them within the preceding one to two years.
• In 1996, 53.1 % of Indiana women over the age of 50 reported having had both a clinical breast examination and a mammogram within the two years preceding the CDC Behavioral Risk Factor Survey interview.
• In 1996, 79.3% of Indiana women over the age of 40 reported ever having had a mammogram according to the CDC Behavioral Risk Factor Surveillance Study.

For More Information

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• Forms.IN.gov

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