Breast cancer is one of the most common cancers affecting American women, and is second only to lung cancer as a leading cause of cancer death in women. The rates of new female breast cancer cases have risen by 1% per year from 2012 to 2021. Death rates from breast cancer continue to decrease over time, in part, due to a greater emphasis on screening with routine breast exams and mammography.
These screening tools often can detect breast cancer at an earlier stage, when it is more treatable, which helps explain why there has been a decline in the death rates even though the number of breastcancer has risen.
The exact cause of breast cancer has not been established, but there are risk factors that may play a role. A risk factor is a trait or behavior that increases a person's chance of developing a disease or makes a person susceptible to a certain condition. Risk factors for breast cancer include:
- Being female (Breast cancer can occur in men, but it is rare.)
- Getting older
- Having a family history of breast cancer
- Having a personal history of cancer in one breast
- Having your first child after age 30 or never having children
- Not breastfeeding
- Getting your period early in life (before age 12)
- Reaching menopause after age 55
- Being overweight after menopause
- Long-term use of combined (estrogen and progestin) hormone replacement therapy
- Using a birth control method that includes hormones
- Being a carrier of an altered form of the breast cancer gene, BRCA1 or BRCA2 (Genes are the basic unit of heredity. They contain instructions for a cell's development and function, and can be passed on from parents to children.)
- Having received chest radiation
- Drinking alcohol .Women who drink one alcoholic beverage daily have up to a 10% increase in risk compared to those who do not drink. Women who drink 2 - 3 alcoholic beverages daily have about a 20% increased risk.
- A diet that's high in fat and low in fruits and vegetables
- Not being physically active
- Having dense breast tissue
- Having certain benign breast issues such as fibroadenoma, ductal hyperplasia, sclerosing adenosis, papillomatosis, lobular carcinoma in situ
- Exposure to diethylstilbestrol (DES)
Does Race or Ethnicity Affect Breast Cancer Risk?
All women should be aware of their risk for breast cancer. It can affect women of every age, race, and ethnic group. However, the rates of developing and dying from breast cancer vary among various racial and ethnic groups.
According to the National Cancer Institute, white, non-Hispanic women have the highest overall incidence rate for breast cancer among U.S. racial/ethnic groups, while Hispanic women have the lowest rate.Among young women ages 20 - 39, African-American women have a higher incidence of breast cancer than white women. African-American women have the highest death rate from breast cancer. Asian-American women have the lowest death rate.
The higher death rate from breast cancer among African-American women has been linked to the stage, or extent, of the cancer at the time it's diagnosed. Studies show that African-American women tend to seek treatment when their cancer is in a more advanced, less treatable stage.
In addition, a higher percentage of African-Americans and Hispanics lack a regular source of health care, such as a primary care provider. Having a primary care provider increases the chance that a person will receive appropriate preventive care -- including routine check-ups and screenings -- that may detect breast cancer at an early stage.
Several other factors have been found to impact the breast cancer incidence and death rates among racial and ethnic groups. Differences in certain lifestyle behaviors -- such as diet, exercise, and acceptability of smoking and alcohol use -- may raise the risk of many diseases, including heart disease and breast cancer.
There are also various factors that may contribute to the lower rates of routine and preventive health care among minority populations, including:
- Socioeconomic factors. These include income level, lack of transportation, and lack of access to health insurance or healthcare facilities, including screening programs.
- Language and communication barriers. These barriers can interfere with a person's ability to discuss health concerns and develop trust in a primary care physician.
- Education about or understanding of health care risks and symptoms. Women who are not aware of breast cancer risks and symptoms are more likely to wait to seek treatment until their symptoms interfere with daily tasks.
- Cultural practices and expectations. Women of some cultures may turn to traditional or "folk" remedies before seeking treatment from a doctor.
- Cultural and/or religious beliefs related to health and health care. Strong beliefs in healing and miracles, as well as distrust of the healthcare system, may keep some people from participating in routine preventive care.
There continues to be an enormous need for more education and resources to reach women, particularly minorities, with the message of breast cancer screening and prevention. For those who are at high risk, careful monitoring and follow-up care with a primary care provider are especially vital.
