Chances are, you know someone who’s been diagnosed with breast cancer. About one in eight women in the U.S. will develop the invasive disease during their lives. If you don’t know someone personally, you probably have a friend who’s mom, aunt, or grandma received the diagnosis. You’ve seen people running “for the cure” in fuchsia tutus, you’ve probably bought the baby pink merch, whether it came in the form of a rubber wristband or a Peloton sports bra.
You know the people, the charities, the ribbon symbol. But how much do you actually know about the cancer itself, and who it’s most likely to affect. This morning, the American Cancer Society released a new study showing who breast cancer impacts, and what’s going on with death rates. Notably, it found that breast cancer is now the leading cause of cancer death for Black women in six states, Carol DeSantis, MPH, lead author of the report, told Refinery29. And although deaths from breast cancer have been rapidly declining since 1989, they noticed in their report that the decline has slowed since 2011. “It’s slowing slightly," DeSantis said. “It was surprising. This is the first time we’ve noted that happening.” She couldn’t say for sure what was slowing the decline, but said it could have to do with a saturation of certain groups of patients who have been steadily benefiting from advances in early detection, treatment, and technology.
Here’s what else you need to know about breast cancer, and who’s likely to get it.
Dr. Dorraya El-Ashry, Ph.D., the Breast Cancer Research Foundation’s Chief Scientific Officer, says that breast cancer risk increases as you age. “There are a number of facets associated with great risk, and age is definitely one of them,” she says.
According to the new ACS report, 82% of breast cancers are diagnosed in women older than 50. The probability of a diagnosis is highest for women who are in their 70s, and breast cancer death is more likely for women in their 80s.
However, preventative care should start earlier than that for some. For the record, some of the leading cancer organizations offer differing guidance on screening. The U.S. Preventive Services Task Force says that women between 50 and 74 years old should get a mammogram every other year, and those under 50 should make individual decisions based on their medical history, and other factors. Meanwhile, American College of Obstetricians and Gynecologists recommends a mammogram yearly or every other year for women considered average risk, beginning at age 40 through age 75. But, if you’re genetically predisposed or present with other risk factors, that guidance changes.
While 1 in 8 women will be diagnosed with breast cancer at some point, the lifetime risk of breast cancer in men is about 1 in 883, according to the ACS. They’ve estimate that in 2019, about 500 men will die from breast cancer, compared to 41,760 women.
Dr. Peter Eby, a radiologist specializing in breast imaging in Seattle and longtime member of the Breast Imaging Society, says that there’s a considerable race disparity between Black and white women when it comes to breast cancer deaths. According to the new ACS report, that disparity has widened over the past three decades.
From 2013 to 2017, the breast cancer death rate was 40% higher in Black women than it was in white women, despite slightly fewer Black women actually being diagnosed with the disease. This is magnified among Black women under 50, among whom the death is double that of white women, according to the new report.
The ACS said it was hard to parse out why this gap was so shockingly wide, but noted that Black women were more likely to be diagnosed at later stages, and have “unfavorable tumor characteristics.”
"There's a real push now to make sure those women start screening at 40 and get screened every year because of their risk for developing more aggressive cancers at a younger age," Eby says.
As far as the decline in deaths by race from breast cancer, the report found that during 2013 to 2017, it declined by 2.1% per year in Latinx women, 1.5% per year in Black women, 1% per year in white women, and .8% per year in Asian women. The numbers stayed the same for Native Americans.
Although there has been plenty of buzz about the BRCA1 and BRCA2 “breast cancer genes” thanks to a rise in popularity in at-home genetic tests and pop culture references in shows such as The Bold Type, only about 5% to 10% of breast cancers are thought to be hereditary, or caused directly by abnormal genes passed from parent to child, according to the ACS.
Eby says that there are steps you can take with your doctor to find out, especially if you’re worried you might have cancer in your family.
“The American College of Radiology and some other groups are now recommending that around 30 years old, you should go to your regular doctor and just say: ‘Hey, I want to be proactive about my health, and know if I’m at increased risk for breast cancer,’” Eby says. “And they can sit down and go through a family tree. Did your mom, sisters, aunts, or grandmothers have it? Then you do a genetic test. That’s one step to take.”
Believe it or not, breast cancer statistics can vary depending on the state. There are a few reasons for this. DeSantis notes that, depending on where you live, there may be different local initiatives that can increase screening among underserved groups, which can help doctors catch the breast cancer at an early and more treatable stage.
The new ACS report notes that during 2016 to 2017, the diagnosis was the leading cause of cancer deaths among Black women in six states, including Arizona, Colorado, Florida, Georgia, Mississippi, and South Carolina. Same went for white women in Utah. This surpassed lung cancer, another aggressive and deadly condition that affects one in 17 women during their lifetime. In four other states, Alabama, Massachusetts, New York, and Texas, the numbers of breast and lung cancer deaths among Black women were similar.
This is the bottom line, according to DeSantis: “More can and should be done to ensure that all women have access to quality care to help eliminate disparities and further reduce breast cancer mortality,”