Women are being diagnosed with breast cancer at higher rates than before, according to the latest data from the American Cancer Society. Researchers say they’re concerned because the increase is steeper among younger women.
As patient advocates and groups sound the alarm, a Kansas expert said one thing remains critical for women to have the best chance of successful treatment or survival.
“Early detection — that goes to getting your mammograms annually,” said Dr. Jamie Wagner, vice chair of clinical affairs and division chief of breast surgical oncology in the surgery department and breast program director at the University of Kansas Cancer Center.
Breast cancer remains the most common cancer among U.S. women, with nearly 311,000 new cases of invasive breast cancer expected to be diagnosed in women this year, according to the American Cancer Society. The group estimates breast cancer will kill more than 42,000 women this year.
In the national report, researchers said they found a “concerning” trend in breast cancer incidence, or the rate at which the disease is diagnosed in a certain population. Incidence generally increases with age until women are in their 70s, and then it begins to decline, likely because of less screening after that point, according to historical data.
The new report found that breast cancer incidence rose by 1% annually from 2012 to 2021, with a slightly steeper trend (1.4 % per year) among women younger than 50 than in women who were older (0.7% per year).
Researchers suggested it reflects changing patterns in some risk factors that are associated with breast cancer, such as increased body weight and fewer or later childbirths. They also said the increase in more recent years could reflect patients trying to “catch up” with their mammograms and other screenings after having postponed them during the COVID-19 pandemic.
Other breast cancer organizations are joining the effort to boost awareness after the data was released. Leaders at Susan G. Komen, one of the largest breast cancer research and advocacy groups, said that even a slight rise in incidence is a “call to action for young women.”
“This data confirms the need for women of all ages to know their personal breast cancer risk so that they can have informed conversations with their health care providers about the screening plan that’s right for them,” said Victoria Wolodzko Smart, senior vice president of mission at Susan G. Komen, in a statement.
The American Cancer Society data aligns with findings released earlier this year by Washington University School of Medicine in St. Louis, Missouri. Researchers there found that diagnoses of breast cancer have increased steadily in women under age 50 over the past two decades, with steeper increases in more recent years.
Breast cancer diagnoses among young women also have made headlines in recent years as more American celebrities have discussed their personal experiences. Actor Christina Applegate was 36 when she received her diagnosis, and 44-year-old actor Olivia Munn went public with her breast cancer battle earlier this year.
Grammy Award-winning musician Sheryl Crow was diagnosed with breast cancer after a routine mammogram in 2006 at age 44.
"Until we have a cure, early detection is our best weapon," she told CBS News in 2022.
Mammography and more
Health experts couldn’t agree more.
Wagner, the KU oncologist, said mammogram screening remains the single best tool for detecting breast cancer early for most women. A mammogram, which is an X-ray image of the breast, can sometimes find breast cancer up to three years before it can be felt as a lump, according to the U.S. Centers for Disease Control and Prevention.
Guidelines for who should get a mammogram, and when, are frequently evolving. And different organizations are sometimes at odds with one another.
Currently, the U.S. Preventive Services Task Force recommends that women who are 40 to 74 years old and at average risk for breast cancer get a mammogram every two years.
For women at average risk, the American Cancer Society recommends optional mammograms for women between 40 and 44, regular annual mammograms for women between 45 and 54, and a mammogram every other year for women 55 and older.
Regardless of the differing advice, Wagner said the main takeaway is simple.
“Everyone needs a mammogram,” she said in an interview.
Mammograms are typically free or low cost for women with insurance, and many nonprofit organizations and foundations help uninsured or underinsured women with the cost.
And what about even younger women? Women younger than 40, for whom mammograms aren’t generally recommended unless they have significant risk factors, are more likely to be diagnosed at later stages with more aggressive breast cancers than older women, when there are fewer treatment options available, according to Susan G. Komen.
Wagner said the best thing a woman can do is know her own body.
Routine self-exams, the kind that were to be conducted monthly while in the shower, aren’t necessarily recommended anymore, she said. Instead, women should be intimately familiar with their breasts on an ongoing basis – enough to know when something looks or feels off.
“No breasts feel the same,” she said. “What we really advocate is know your body, and if something changes, be a self-advocate.”
Wagner said women can also control, to a certain degree, some factors that increase the risk of breast cancer, such as keeping a nutritious diet, exercising, monitoring alcohol intake and maintaining a healthy body weight.
Declining mortality rates
The American Cancer Society report also showed good news: Breast cancer mortality rates have dropped by 44% since 1989, which translates to approximately 517,900 fewer women dying during this time period.
“The encouraging news is breast cancer mortality rates continue to decrease thanks to advances in early detection and treatment,” said Angela Giaquinto, associate scientist at the American Cancer Society and the study’s lead author, in a statement.
Wagner agreed, saying that a combination of better diagnosing abilities and more targeted treatment options have led to the mortality rate decline. Doctors also have a better understanding of breasts and the different types of cancer that can afflict them, she said.
“We understand it isn’t just breast cancer anymore. It’s a family of cancers, and they all have different personality types,” she said. “That led us into an era where we have tailored treatments.”
Screening methods have improved over the years, too, Wagner said. The standard of care is now 3D mammography, which can help find cancers not detected in traditional 2D mammography, especially in women with dense breasts.
“We have such a firm belief in that,” she said. “That was a turning point about a decade ago.”
For women who may require supplemental screenings after a routine mammogram, MRI, or magnetic resonance imaging, has been a “fantastic” addition to screening options, and contrast-enhanced mammography also has become “incredibly helpful” for some, Wagner said.
“When you put that entire package of imaging modalities together,” she said, “we have the opportunity to diagnose a lot of things really early.”
And to keep the mortality rate on a downward trend? It all comes back to finding breast cancer early.
“We need to change the conversation around early detection so we’re doing more to find the young women who are at higher risk and ensure they get the care they need, without financial barriers,” said Wolodzko Smart, of Susan G. Komen, in a statement.
Emily Younker is the news editor of the Kansas News Service. Email her at eyounker@kcur.org.
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