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About Breast Cancer
Breast cancer is the second leading cause of cancer death, and excluding skin cancers, the most frequently diagnosed cancer among women in Indiana and the United States. In Indiana, there were approximately 4,636 cases of invasive breast cancer diagnosed during 2016. Sex and age are the two greatest risk factors for developing breast cancer. Women have a much greater risk of developing breast cancer, and that risk increases with age. Breast cancer is rare among men; however, they are often diagnosed at later stages and have poorer prognoses.
Factors associated with increased breast cancer risk include weight gain after the age of 18, being overweight or obese, use of menopausal hormone therapy, physical inactivity, and alcohol consumption. Research also indicates that long-term, heavy smoking increases breast cancer risk, particularly among women who start smoking before their first pregnancy. The International Agency for Research on Cancer has concluded that shift work, especially at night, may be associated with an increased risk of breast cancer.
Additional risk factors include:
- Family history – Women who have had one or more first degree relatives who have been diagnosed with breast cancer have an increased risk. Additionally, risk increases if a woman has a family member who carries the breast cancer susceptibility genes (BRCA1 or 2).
Race – In Indiana, during 2016, the breast cancer incidence rates for African-American and white women were similar, but the mortality rate for African-American women was 46 percent higher than for whites.
Reproductive factors – Women may have an increased risk if they have a long menstrual history (menstrual periods that start early and/or end later in life), have recently used oral contraceptives, have never had children, had their first child after the age of 30, or have high natural levels of sex hormones.
Certain medical findings – High breast tissue density, high bone mineral density, type 2 diabetes, certain benign breast conditions, and lobular carcinoma in situ can increase a woman’s risk of developing breast cancer. In addition, high dose radiation to the chest for cancer treatment increases risk.
Factors associated with a decreased risk of breast cancer include breastfeeding for at least one year, regular moderate or vigorous physical activity, and maintaining a healthy body weight. Two medications – tamoxifen and raloxifene – have been approved to reduce breast cancer risk in women at high risk.
Common Signs and Symptoms of Breast Cancer
Lumps, hard knots or thickening
Swelling, warmth, redness or darkening
Pulling in of the nipple or other parts of the breast
Change in size or shape
Nipple discharge that starts suddenly
Dimpling or puckering of the skin
Itchy, scaly sore or rash on the nipple
New pain in one spot that doesn’t go away
Breast Cancer Screening
Women should have frequent conversations with their health care provider about their risks for breast cancer and how often they should be screened. The United States Preventive Services Task Force recommends a screening mammogram every two years for women aged 50 to 74, which help detect cancers before a lump can be felt. Women between the ages of 40 to 49, especially women with a family history of breast cancer, should discuss the risks and benefits of mammography with their health provider to determine if it is right for them.
According to the 2016 Indiana Behavioral Risk Factor Surveillance System, 72.5 percent of women ages 50 to 74 had a mammogram during the past two years.
The Affordable Care Act requires preventive screening services to be included in most insurance policies. Often, these services are paid in full. Individuals should check with their individual insurance providers for specific plan information.
The Indiana Breast and Cervical Cancer Program (BCCP) is the Hoosier implementation of the National Breast and Cervical Cancer Early Detection Program. The BCCP provides access to breast and cervical cancer screenings, diagnostic testing and treatment for underserved and underinsured women who quality for services. Visit http://www.in.gov/isdh/24967.htm for more information and eligibility requirements.