Breast cancer epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]Rim Halaby, M.D. [3]; Assistant Editor(s)-In-Chief: Jack Khouri; Mirdula Sharma, MBBS [4]

Overview

The prevalence of breast cancer is approximately 124.8 per 100,000 women per year. The number of deaths was 21.9 per 100,000 women per year, based on 2010-2012 data.

Epidemiology and Demographics

• About 1 out of 8 women in United states will develop invasive breast cancer.
• Annually (i . e in 2019) around 268,600 and 62,930 new cases of invasive and non-invasive (in situ) breast cancer are expected to be diagnosed respectively.
• In men, life time likelihood of developing breast cancer is about 1 in 883.
• Annually 2,670 new cases of invasive breast cancer are expected to be diagnosed in males.
• Breast cancer increasing pattern of incidence rates began decreasing after year 2000 in US.
• According to the results of the Women’s Health Initiative study ,published in 2002, reduced use of hormone replacement therapy (HRT) by US women might explain the observed decreasing pattern of incidence.
• Around 42000 women in the U.S. are expected to die annually from breast cancer.
• Women under 50 have experienced larger decreases.
• A decreasing pattern of death rates has been observed since 1989 which might be explained by treatment advances, earlier cancer detection courtesy of screening programs, and increased awareness.
• In the subgroup of women under 45, African-American women breast incidence of breast cancer is higher compared to the white women, and they are more likely to die of breast cancer.
• Asian, Hispanic, and Native-American women, have a lower risk of developing and dying from breast cancer.

Incidence

• The following tables represent age-adjusted SEER incidence rates, 2011-2015.

Age-Adjusted SEER Incidence^a Rates, 2011-2015

Age at Diagnosis	All Races, Females	White Females	Black Females
All ages	31.1	30.8	32.1
Under 65	23.1	22.9	21.9
65 and over	86.7	85.3	102.9
All ages (WHO world std)b	25.3	25.0	25.

Age-Specific SEER Incidence Rates, 2011-2015

Age at Diagnosis	All Races, Females	White Females	Black Females
<1	-	-	-
1-4	-	-	-
5-9	-	-	-
10-14	-	-	-
15-19	-	-	-
20-24	0.2	0.2	-
25-29	0.7	0.6	0.8
30-34	2.7	2.4	3.1
35-39	9.6	9.7	8.6
40-44	40.7	40.5	34.5
45-49	62.5	62.9	49.4
50-54	70.5	70.6	62.9
55-59	73.1	71.4	79.2
60-64	86.6	84.0	101.7
65-69	108.4	105.9	122.0
70-74	103.4	101.1	123.2
75-79	88.0	87.0	112.8
80-84	64.3	64.2	74.9
85+	28.4	28.2	34.4

Footnotes: ^a SEER 18 areas. Rates are per 100,000 and are age-adjusted to the 2000 US Std Population (19 age groups - Census P25-1130), unless noted.

^b Rates are per 100,000 and are age-adjusted to the world (WHO 2000-2025) standard million.

- Statistic not shown. Rate based on less than 16 cases for the time interval.

• Estimated new breast cancer cases in 2018 was 266,120 which made 15% of all new caner cases.
• The incidence of breast cancer varies greatly around the world: it is lowest in less-developed countries and greatest in the more-developed countries.
• In the twelve world regions, the annual age-standardized incidence rates per 100,000 women are as follows:

• in Eastern Asia,18;
• South Central Asia, 22;
• Sub-Saharan Africa, 22;
• South-Eastern Asia, 26;
• North Africa and Western Asia, 28;
• South and Central America, 42;
• Eastern Europe, 49;
• Southern Europe, 56;
• Northern Europe, 73;
• Oceania, 74;
• Western Europe, 78;
• and in North America, 90.

Prevalence

• In 2019, around 3.1 million women are living with breast cancer in the United States.
• Approximately 12.3 percent of women will be diagnosed with female breast cancer at some point during their lifetime.

• Worldwide, breast cancer is the most common invasive cancer in women. (The most common form of cancer is non-invasive non-melanoma skin cancer; non-invasive cancers are generally easily cured, cause very few deaths, and are routinely excluded from cancer statistics.) Breast cancer comprises 22.9% of invasive cancers in women and 16% of all female cancers.

• In the United States, breast cancer is the third most common cause of cancer death (after lung cancer and colon cancer). In 2007, breast cancer caused approximately 40,910 deaths (7% of cancer deaths; almost 2% of all deaths) in the U.S.
• Among women in the U.S., breast cancer is the most common cancer and the second- most common cause of cancer death (after lung cancer). Women in the U.S. have a 1 in 8 lifetime chance of developing invasive breast cancer and a 1 in 33 chance of breast cancer causing their death. A U.S. study conducted in 2005 by the Society for Women's Health Research indicated that breast cancer remains the most feared disease, even though heart disease is a much more common cause of death among women.

• Since the 1970s, The number of cases has significantly increased, a phenomenon partly blamed on modern lifestyles in the Western world.
• According to the results of the Women’s Health Initiative study ,published in 2002, reduced use of hormone replacement therapy (HRT) by US women might explain the observed decreasing pattern of incidence.
• Because the breast is composed of identical tissues in males and females, breast cancer also occurs in males, although it is less common.

Case Fatality Rate

• Estimated death due to breast cancer in 2018 was 40,920 which made 6.7% of all caner induced death.
• The number of deaths was 21.9 per 100,000 women per year, based on 2010-2012 data.
• A decreasing pattern of death rates has been observed since 1989 which might be explained by treatment advances, earlier cancer detection courtesy of screening programs, and increased awareness.

Breast cancer incidence and death rates (1992-2015). Courtesy of SEER data base website. https://seer.cancer.gov/statfacts/html/breast.html

Age

Invasive Breast Cancer

• While the overall age-adjusted incidence of invasive breast cancer among males and females in the United States between 2007 and 2011 is 67.1 per 100,000, the age-adjusted incidence of invasive breast cancer by age category is:
  • Under 65 years: 41.9 per 100,000
  • 65 and over: 241.6 per 100,000

• Among females, only, the overall age-adjusted incidence of invasive breast cancer in the United States between 2007 and 2011 is 124.5 per 100,000, whereas the age-adjusted incidence of invasive breast cancer by age category is:
  • Under 65 years: 81.7 per 100,000
  • 65 and over: 420.3 per 100,000

• Shown below is an image depicting the incidence of breast cancer by age and race in the United States between 1975 and 2011.

In-Situ Breast Cancer

• Among females only, the overall age-adjusted incidence of in-situ breast cancer in the United States between 2007 and 2011 is 31.7 per 100,000, whereas the age-adjusted incidence of invasive breast cancer by age category is:
  • Under 65 years: 23.6 per 100,000
  • 65 and over: 87.7 per 100,000

• Shown below is an image depicting the incidence of in-situ versus invasive breast cancer in females in the United States between 1975 and 2011.

Gender

• In the United States, the age-adjusted prevalence of invasive breast cancer by gender in 2011 is:
  • In males: 8.3 per 100,000
  • In females: 1222.3 per 100,000

Sex

Men have a lower risk of developing breast cancer (approximately 1.08 per 100,000 men per year), however, this risk appears to be rising.

Race

• Shown below is a table depicting the age-adjusted prevalence of invasive breast cancer by race in females and males in 2011 in the United States.

	All Races	White	Black	Asian/Pacific Islander	Hispanic
Age-adjusted prevalence	666.3 per 100,000	700.1 per 100,000	592.9 per 100,000	510.9 per 100,000	460.5 per 100,000

• Shown below is a table depicting the age-adjusted prevalence of invasive breast cancer by race in females in in 2011 in the United States.

	All Races	White	Black	Asian/Pacific Islander	Hispanic
Age-adjusted prevalence	1222.3 per 100,000	1300.2 per 100,000	1026.1 per 100,000	916 per 100,000	835.9 per 100,000

• Shown below is an image depicting the incidence of breast cancer by race in the United States between 1975 and 2011.

API: Asian/Pacific Islander; AI/AN: American Indian/ Alaska Native

Developing Countries

"Breast cancer in less developed countries, such as those in South America, is a major public health issue. It is a leading cause of cancer-related deaths in women in countries such as Argentina, Uruguay, and Brazil. The expected numbers of new cases and deaths due to breast cancer in South America for the year 2001 are approximately 70,000 and 30,000, respectively." However, because of a lack of funding and resources, treatment is not always available to those suffering with breast cancer.

References

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