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Breast cancer deaths continue decline

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Breast cancer deaths in the United States have declined continuously about 2% a year since 1990, according to a new report from the American Cancer Society. The report estimates that about 192,370 American women will be diagnosed with the disease this year and 40,170 will die from it. Only lung cancer accounts for more cancer deaths in women. For the last 10 years of that period, death rates in African American women have declined at the same rate as those in Caucasians, but the death rate still remains 40% higher in that group. Based on the latest data, relative survival rates for women with breast cancer are:

- 89% at five years after diagnosis;

- 82% after 10 years;

- 75% after 15 years.

The incidence of new breast cancer cases has gone through five distinct phases, according to the report. Between 1975, when the ACS first began collecting data, and 1980, the incidence of new cases was essentially constant. Between 1980 and 1987, the incidence grew by an average of 4% per year, largely as a result of the growing use of mammography, which detects tumors earlier that physical breast examination. Between 1987 and 1994, the incidence again remained constant.

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Starting in 1994, however, the incidence began to grow by 1.6% per year. Many experts attribute this growth to expanding use of hormone replacement therapy, which was shown in 2002 to increase a woman’s risk of developing breast cancer. Between 1999 and 2006, the most recent year for which data are available, the incidence declined by an average of 2% per year. That average was driven by a sharp decrease in incidence between 2002 and 2003, a period during which large numbers of women stopped using hormone replacement therapy because of the new data about its risks. Some of the declining incidence may also be attributable to decreased use of mammography during the period.

About 1% of all U.S. breast cancer cases occur in men and the incidence has been growing at about 0.9% per year since 1975. Death rates have remained essentially constant during the period, however. Risk factors for male breast cancer include BRCA gene mutations, Klinefelter syndrome, testicular disorders, family history of male or female breast cancer and obesity.

-- Thomas H. Maugh II

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