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Breast Cancer Death Rates Continue to Fall

But decline is greater among white women than black women, report finds

TUESDAY, Sept. 25 (HealthDay News) -- Breast cancer death rates continue to decline more than 2 percent annually, a long-running trend that can be traced to early detection and better treatments, according to a new American Cancer Society report.

However, the death rates are not declining as quickly among black women as among white and Hispanic women.

In 2007, about 178,480 new cases of invasive breast cancer will be diagnosed in American women, and another 62,030 cases of localized breast cancer will be found. About 40,460 women are expected to die from the disease this year, second only to lung cancer, the report said.

The decline in overall reported breast cancer cases, beginning in 2000, is believed to be related to two factors. One is the decreased use of hormone replacement therapy, which has been linked to a multitude of health risks, including breast cancer.

The other factor could be potentially troubling, experts say: A decrease in mammography screening, resulting in fewer cancers being detected. While 70 percent of women aged 40 and older said they had had a mammogram within the past two years in 2000, just 66 percent did in 2005.

Aside from skin cancer, breast cancer is the most frequently diagnosed cancer among U.S. women, accounting for more than one in four malignancies detected in women, said the report. It has been published every two years since 1996.

Among other findings in the report, titled Breast Cancer Facts & Figures 2007-2008:

  • From 1995-2004, the drop in breast cancer death rates was highest in whites and Hispanics/Latinas, at 2.4 percent per year, but lower in blacks, at 1.6 percent annually. It remained unchanged among other racial and ethnic groups, including Asian-Americans/Pacific Islanders and American Indians/Alaska Natives.
  • Breast cancer incidence rates have been declining sharply since 2001, by nearly 5 percent annually, in women aged 50 and older, partly due to the drop in use of hormone replacement therapy. Incidence rates in younger women, however, have remained stable since 1986.
  • Although breast cancer in men is rare, the incidence in males increased 1 percent a year between 1975 and 2004. The cause is not known.

"For women concerned about the risk of developing and dying from breast cancer, probably still the most important advice is to get regular mammograms as recommended by the American Cancer Society," said Elizabeth Ward, director of surveillance research for the cancer society, and a contributor to the report.

Other preventive measures, said Ward: "If you have a family history, you should be talking about that history with your doctor. It may be recommended to begin screening sooner [than age 40]. Women should try to maintain a healthy weight all through their life. Women should consume no more than one alcoholic beverage a day. Exercise is also a good way to decrease risk. Physical activity has a small protective effect."

Dr. Eric P. Winer, director of the breast oncology center at the Dana-Farber Cancer Institute in Boston, and chief scientific advisor for Susan G. Komen for the Cure, said the new report contains "both good and bad news."

"It is clear that we have new diagnostic tools that have the potential to allow us to detect breast cancer at even earlier stages," Winer said. "Perhaps more importantly, we also have many new treatment strategies. These treatments, particularly if properly applied, will save lives and reduce suffering. There has been, and continues to be, a decline in death from breast cancer."

Still, Winer added, the report contains some troubling news, including the divergence in breast cancer rates between white and black women. It's a trend, he said, that "almost certainly relates to access to care and access to the best possible care."

"In spite of our best efforts, a substantial minority of women continue to be diagnosed when the disease has advanced to stage IV and is no longer curable. Again, this is a small minority, but it still represents a significant number of women," he said.

"In some cases, the cause of this is that women did not have access to health care. In other cases, it is because breast cancer can, at times, be quite aggressive and simply cannot be caught before it has spread. To combat this problem, we need greater access to care for all Americans and we need better treatment approaches."

More information

To learn more about the report, visit the American Cancer Society.

SOURCES: Elizabeth Ward, Ph.D., director, surveillance research, American Cancer Society, Atlanta; Eric P. Winer, M.D., chief scientific advisor, Susan G. Komen for the Cure, and director, breast oncology center, Dana-Farber Cancer Institute, Boston; Sept. 25, 2007, Breast Cancer Facts & Figures 2007-2008

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