We've entered the month of pink. As most of you know, October is breast cancer awareness month. Breast cancer is the most common cancer among women. It affects more than 230,000 women each year, and about 30,000 women still die from this disease each year. We have come a long way in regards to the five-year survival rate for breast cancer. The current five-year survival rate for breast cancer in the United States is 90 percent, compared to 75 percent back in the 1970s. This is a result of early screening and early detection. The most important screening tool remains the mammogram, because of its 90 percent efficiency rate of diagnosing the disease early.
Key statistics for breast cancer (according to BreastCancer.org):
- About 1 in 8 American women will develop invasive breast cancer over the course of her lifetime.
- For women in the United States, breast cancer death rates are higher than those for any other cancer, besides lung cancer.
- About 85 percent of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations.
- The most significant risk factors for breast cancer are being a woman and being older in age.
- Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women.
There have been three paramount findings that have changed the narrative around breast cancer in 2015. Here's what you need to know.
1. Breast cancer rates are expected to rise 50 percent by 2030 in America
A new study from the National Cancer Institute is predicting that the number of breast cancer cases diagnosed each year in the U.S. could rise 50 percent in the next 15 years. The study estimates that by 2030, there will be 441,000 new breast cancers diagnosed yearly in U.S. women ages 30 to 84. That's up from 283,000 breast cancer cases in 2011.
- Our population is growing
- People are living longer and an individual's risk of cancer increases with age
- Various generations of women have different in lifestyle factors that may affect their risk
- For example, women in today's older generations may have been less likely to have breastfeed their children, which may lower their risk.
2. New blood test could detect likelihood of breast cancer recurrence
One of the major challenges with breast cancer is determining those at the highest risk for experiencing recurrence after having been treated, which often requires chemotherapy. Scientists have been working on improving this factor that breast cancer survivor's face by utilizing newer science around genetic testing in order to detect a woman's risk. Researchers from London have released new findings showing the discovery of a new blood test that can detect breast cancer DNA months before it would appear on medical scans.
While this blood test is not yet available, the research is quite promising. The study involved 55 women where researchers analyzed DNA that was abnormal in the breast cancer tumor. They took early tumors and identified what the mutations were. All cancers have mutations. When a tumor's DNA develops cancerous mutations, they rapidly proliferate, and cause a growing tumor. They then isolated it and developed a blood test which follows the blood in women who have previously had breast cancer to see if their breast cancer recurred.
The results showed that among the 15 women who had breast cancer recurrences, they found it early in 12 out of the 15. The other three women unfortunately experienced metastasis to the brain in which case they may not have been able to find it in the blood anyways since it already spread beyond the breast. This is groundbreaking because it could eventually mean that we may be able to determine that breast cancer (or any cancer) is metastasizing, or spreading, before it actually does.
According to a study published in Science Translation Medicine, women who test positive for breast cancer tumor DNA after having breast cancer surgery and chemotherapy are 12 times as likely to experience a recurrence compared to women who test negative for tumor DNA. Being able to predict the metastasis of cancer would allow patients to be treated before the disease spreads beyond the tumor site.
3. The link between breast cancer and ovarian cancer
A recent study showed that there has been a 20 percent increase in breast cancer awareness since actress Angelina Jolie went public with her breast cancer story and being tested for the BRCA gene. Jolie explained in an op-ed piece that her having the BRCA1 gene mutation gave her an estimated 87 percent risk of developing breast cancer and 50 percent risk of developing ovarian cancer. Many women want to know if they should get the BRCA gene test. While it is important to discuss this test with your doctor, the National Cancer Institute says that the BRCA test may be appropriate for women who have a personal or family history that suggests the possible presence of a BRCA mutation.
Family history factors that are associated with an increased likelihood of having a BRCA mutation include having been diagnosed with breast cancer before age 50, cancer in both breasts in the same woman, both breast and ovarian cancers in either the same woman or the same family, multiple breast cancers, two or more primary types of BRCA1- or BRCA2-related cancers in a single family member, cases of male breast cancer, or Ashkenazi Jewish ethnicity.
For most people, cancer is something that occurs later in life, as gene mutations that cause cancer develop and accumulate over the course of a lifetime of microscopic wear and tear. In a smaller subset of people, this gene mutation is something that they inherited. And have had since they were born. Unfortunately, this damaged gene puts them at higher risk for cancer than most people.
For breast and ovarian cancers, mutations in one of two genes, BRCA1 or BRCA2, will greatly increase the risk for both cancers. With this hereditary gene mutation, if you are diagnosed with breast cancer, the chances you will have ovarian cancer later in life are substantially higher. And vice versa if you are diagnosed with ovarian cancer first.
We see this in the case of Angelina Jolie, whose family history and inherited BRCA gene mutation led her to have a risk reducing double mastectomy almost two years ago. Moreover, she has also just recently undergone preventative surgery to remove her ovaries and fallopian tubes. Two major surgeries in two years, based mainly on risk factors.
Knowing your risk can help you make the right medical decisions for yourself, as Angelina Jolie did in her preventative measure. Cancer gene testing is rather simple, and can be performed on either a blood or cheek swab sample.
The results of this can tell if a person has one of the two BRCA mutations, and indicate whether they are at an increased risk for breast and ovarian cancers. People with an inherited gene mutation have a 50 percent chance of passing this on to their children, so if you have had either breast or ovarian cancer, getting genetic testing may provide critical information for your children in the future. Although this test does not indicate for cancer -- it provides important information for medical decision making.
What are the risk factors for breast cancer?
- Age. Risk goes up with age. About 2 out of 3 invasive breast cancers are found in women aged 55 or older while 1 out of 8 are found in women younger than 45.
- Gender. Being a woman is the main risk factor. Men can get it too, but it is about 100 times more common in women.
- Family history. Risk is doubled if you have a first-degree relative (i.e. sister, mother, daughter) who has been diagnosed with breast cancer.
- Genetics. About 5 to 10 percent of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.
- Personal history. If you have previously had breast cancer, you are 3 to 4 times more likely to develop cancer in the other breast or a different part of the same breast. This risk is different from the risk of recurrence.
- Race/Ethnicity. Caucasian women have a slightly higher risk of developing breast cancer compared to African American, Hispanic, and Asian women. However, African American women are more likely to develop more aggressive, more advanced-stage breast cancer that is diagnosed at a young age and are more likely to die from the disease.
