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What Is The Average Risk Of Breast Cancer

Benefits Of Mammographic Screening

What is My Risk for Breast Cancer? | Duke Health

The ACS systematic review also examined the effect of screening mammography on life expectancy. Although the review concluded that there was high-quality evidence that mammographic screening increases life expectancy by decreasing breast cancer mortality, the authors were not able to estimate the size of the increase 23.

What Are The Recommendations For Early Detection

Those at a high risk of breast cancer can benefit from additional monitoring or screening. This can help to detect and begin treatment for breast cancer early.

Doctors may also spread out screening tests by 6 months to increase surveillance to two times a year, rather than once a year. For example, they may recommend a mammogram in January and an MRI in June.

Currently, the ACS recommends that the following people receive both a mammogram and a breast MRI each year, often starting at age 30:

  • those with a lifetime risk of breast cancer of 20 to 25 percent or more based on risk assessment tools
  • individuals with a known mutation in BRCA1 or BRCA2 or those who have a close relative with a known BRCA1 or BRCA2 mutation
  • people who received radiation therapy to their chest area between the ages of 10 and 30
  • those with a personal or family history of the following family cancer syndromes:
  • Li-Fraumeni syndrome
  • Cowden syndrome
  • Bannayan-Riley-Ruvalcaba syndrome

There are benefits to using both types of screening technology. Although a breast MRI is more likely to find cancer, it may miss changes that a mammogram would detect.

Additionally, the ACS states that theres currently not enough evidence to recommend a yearly breast MRI for people with dense breasts or a history of breast conditions like DCIS, LCIS, ADH, and ALH.

Risk Prediction Models For Breast Cancer

Risk prediction models and appropriate clinical applications are summarized in Table 1 and Table 2. The risk prediction models are divided into regression models and genetic risk models. In regression models, risk calculations are based on the combination of a regression model with population-based incidence rates . In genetic risk models, segregation analysis is used to estimate the likelihood of harboring a genetic mutation based on family pedigree data, and then the penetration of that mutation is used to determine age-specific risk . Some models, such as the TyrerCuzick model, incorporate both regression and genetic risk but are listed in the genetic risk section of this article.

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Absolute Risk And Relative Risk

Understanding the terms absolute risk and relative risk can help you better understand your own risk of breast cancer.

The absolute risk of a disease describes a persons risk of developing the disease in this case, breast cancer over a defined period of time. The National Cancer Institute and American Cancer Society report the absolute risk of breast cancer in the general population over a lifetime. So, for the average U.S. woman , 12.9% is the absolute risk of developing breast cancer at some point during her life.

Relative risk compares the risk of two different groups of people. Relative risk also can tell you how much something you do can change your risk compared to your absolute risk.

Some examples may help explain the difference.

We know the absolute risk of breast cancer in U.S. women is 12.9%. A 2017 study found that women who started smoking before age 17 had a 24% higher risk of breast cancer.

This 24% increase in risk is relative risk. It doesnt mean that women who start smoking before age 17 have a 24% risk of developing breast cancer some time in their lives. It means their risk is 24% higher than the average risk of 12.9%.

To figure out the increase in absolute risk, we have to do some math: 24% of 12.9% is 3% . So a woman who started smoking before age 17 has a 3% increase in absolute risk, which means her lifetime risk of developing breast cancer is 15.9% .

Now lets look at an example of breast cancer risk decreasing.

Your Race And Ethnicity

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White and Black women have the highest risk of developing breast cancer in their lifetime. Asian/Pacific Islander and Hispanic/Latina womens breast cancer rates fall in between two major groupings while American Indian and Alaska Native women are on the lowest end of risk.

While white women are more likely to develop breast cancer than Black women overall, they tend to be diagnosed at an older age . Black women have the highest breast cancer rates among women under age 40. Black women make up a higher percentage of triple-negative breast cancer cases.

What to do: If your race or ethnicity places you at higher risk, make sure you follow all screening recommendations to improve your chances of catching cancer early.

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The Brca Genes And Beyond: Inherited Risk For Breast Cancer

Women with inherited mutations in the BRCA1 or BRCA2 genes have a higher risk of breast and ovarian cancer than the general population.

About 5 to 10 percent of breast cancer occurs in people with a BRCA gene mutation. About 72 percent of women with a BRCA1 mutation and 69 percent of women with a BRCA2 mutation develop breast cancer before they are 80 years old. Without a BRCA mutation, about 12 percent of women develop breast cancer in their lifetime.

A blood test can analyze your DNA to determine whether you have mutations in either BRCA gene. However, only women with a personal or family history of breast or ovarian cancer, or those of Ashkenazi Jewish ancestry, usually undergo testing.

If you have an average risk of breast or ovarian cancer, it is not typical to get tested for BRCA mutations, and your insurance company is unlikely to cover the cost. However, some private companies offer BRCA gene testing to anyone willing to pay out of pocket.

If you decide to get tested for a BRCA gene mutation, you should seek genetic counseling as well. A counselor can help you understand your test results and your options after you receive them.

Over the years, researchers have identified other inherited genetic mutations that can raise risk, including ATM, PALB2, and TP53, among others.

How Common Is Breast Cancer

Breast cancer is the most common cancer in women in the United States, except for skin cancers. It is about 30% of all new female cancers each year.

The American Cancer Society’s estimates for breast cancer in the United States for 2021 are:

  • About 281,550 new cases of invasive breast cancer will be diagnosed in women.
  • About 49,290 new cases of ductal carcinoma in situ will be diagnosed.
  • About 43,600 women will die from breast cancer.

Breast cancer mainly occurs in middle-aged and older women. The median age at the time of breast cancer diagnosis is 62. This means half of the women who developed breast cancer are 62 years of age or younger when they are diagnosed. A very small number of women diagnosed with breast cancer are younger than 45.

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Symptoms Of Inflammatory Breast Cancer

Inflammatory breast cancer is especially aggressive and grows quickly. However, it often does not cause a lump or show up on a mammogram.

IBC occurs more often in younger women and women who are obese or overweight. Black women may have a higher risk of IBC than women of another race or ethnicity.

IBC symptoms include frequent itching or irritation of the breast, a small rash that might resemble an insect bite, flattened or inverted nipples, or skin changes that look like an orange peel.

The breast often swells and may appear reddish or purplish or even look bruised. At least a third of the breast may feel warmer or heavier than the other. Your breast may feel tender, itchy, or burning.

What Is The Average American Womans Risk Of Being Diagnosed With Breast Cancer At Different Ages

Dr. Christiane Kuhl Discusses Breast MRI Screening of Women at Average Risk of Breast Cancer

Many women are more interested in the risk of being diagnosed with breast cancer at specific ages or over specific time periods than in the risk of being diagnosed at some point during their lifetime. Estimates by decade of life are also less affected by changes in incidence and mortality rates than longer-term estimates. The SEER report estimates the risk of developing breast cancer in 10-year age intervals . According to the current report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is as follows:

  • Age 30 . . . . . . 0.49%
  • Age 40 . . . . . . 1.55%
  • Age 50 . . . . . . 2.40%
  • Age 60 . . . . . . 3.54%
  • Age 70 . . . . . . 4.09%

These risks are averages for the whole population. An individual womans breast cancer risk may be higher or lower depending on known factors, as well as on factors that are not yet fully understood. To calculate an individual womans estimated breast cancer risk, health professionals can use the Breast Cancer Risk Assessment Tool, which takes into account several known breast cancer risk factors.

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Breast And Ovarian Cancer And Family History Risk Categories

This table provides examples of average, moderate, and strong family health histories of breast and ovarian cancer. This may help you understand if you have an increased risk for these cancers based on your family health history.

Note: This table does not include all possible family health histories of breast and ovarian cancer. If you have concerns about your family health history of breast or ovarian cancer, please talk to your doctor. Your doctor may assess your risk based on your personal and family health history, using one of the following:

Results may vary, depending on the tool used, and may differ from the risk categories below, which are based largely on the guidelines from the National Comprehensive Cancer Network.1

Family History Risk Category

Average: Typically not increased risk, similar to the general population risk

Average: Typically not increased risk, similar to the general population risk

No first or second-degree relatives with breast or ovarian cancer

or

One second-degree female relative with breast cancer diagnosed after age 50

No first or second-degree relatives with breast or ovarian cancer

or

One second-degree female relative with breast cancer diagnosed after age 50

Grandmother with breast cancer diagnosed at age 75

Grandmother with breast cancer diagnosed at age 75

Genetic counseling and testing for hereditary breast and ovarian cancer is not typically recommended for this type of family

oror

One first or second-degree relative with:

Your Personal History Of Breast Cancer

If youve been diagnosed with breast cancer in the past, you are more likely to develop a new cancer in the other breast or in another part of the same breast. This is not considered a recurrence but a new breast cancer.

What to do: Follow your cancer teams instructions on monitoring to stay on top of this risk. Ask your doctor whether you should see a genetic counselor.

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Example Of The Impact Of A Relative Risk

Using our example of the exercise study above, we can show how absolute risks affect the number of extra cases.

Inactive women have a 25 percent higher risk of breast cancer than active women .

Since older women are more likely to get breast cancer, a lack of exercise has a greater impact on breast cancer risk in older women than in younger women.

First, lets look at the women in the study ages 70-74 years.

The study finds 500 women per 100,000 who are inactive develop breast cancer in one year. This is the absolute risk for women with the risk factor, lack of exercise.

The study also shows 400 women per 100,000 who are active develop breast cancer in one year. This is the absolute risk for women without the risk factor.

The relative risk is 1.25 for women who are inactive compared to those who are active.

Among women ages 70-74, being inactive led to 100 more cases of breast cancer per 100,000 women in one year .

Now lets look at the women in the study ages 20-29.

The study finds 5 women per 100,000 who were inactive developed breast cancer in one year. And, 4 women per 100,000 who were active got breast cancer.

Here again, the relative risk is 1.25.

However, in women ages 20-29, being inactive led to only 1 extra case of breast cancer per 100,000 women .

So, the same relative risk of 1.25 led to many more extra cases of breast cancer in the older women than in the younger women .

How Has The Risk Of Being Diagnosed With Breast Cancer Changed In Recent Years

Breast Cancer Risk Factors

For a woman born in the 1970s in the United States, the lifetime risk of being diagnosed with breast cancer, based on breast cancer statistics from that time, was just under 10% .

The last five annual SEER Cancer Statistics Review reports show the following estimates of lifetime risk of breast cancer, all very close to a lifetime risk of 1 in 8:

  • 12.83%, based on statistics for 2014 through 2016
  • 12.44%, based on statistics for 2013 through 2015
  • 12.41%, based on statistics for 2012 through 2014
  • 12.43%, based on statistics for 2011 through 2013
  • 12.32%, based on statistics for 2010 through 2012

SEER statisticians expect some variability from year to year. Slight changes may be explained by a variety of factors, including minor changes in risk factor levels in the population, slight changes in breast cancer screening rates, or just random variability inherent in the data.

Selected Reference
  • Howlader N, Noone AM, Krapcho M, et al. . SEER Cancer Statistics Review, 19752017, National Cancer Institute. Bethesda, MD, , based on November 2019 SEER data submission, posted to the SEER web site, April 2020.

  • Related Resources
    • Reviewed:December 16, 2020

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    Breast Cancer Risk Factors

    Everyone wants to know what they can do to lower their risk of breast cancer. Some of the factors associated with breast cancer being a woman, your age, and your genetics, for example can’t be changed. Other factors being overweight, lack of exercise, smoking cigarettes, and eating unhealthy food can be changed by making choices. By choosing the healthiest lifestyle options possible, you can empower yourself and make sure your breast cancer risk is as low as possible.

    The known risk factors for breast cancer are listed below. Click on each link to learn more about the risk factor and ways you can minimize it in your own life. If a factor can’t be changed , you can learn about protective steps you can take that can help keep your risk as low as possible.

    Just being a woman is the biggest risk factor for developing breast cancer. There are about 266,120 new cases of invasive breast cancer and 63,960 cases of non-invasive breast cancer this year in American women.

    As with many other diseases, your risk of breast cancer goes up as you get older. About two out of three invasive breast cancers are found in women 55 or older.

    Women with close relatives who’ve been diagnosed with breast cancer have a higher risk of developing the disease. If you’ve had one first-degree female relative diagnosed with breast cancer, your risk is doubled.

    About 5% to 10% of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.

    Relative Risks Less Than 1

    A relative risk less than 1 means the risk factor lowers the risk of disease.

    For example, women who breastfeed for a year have a relative risk of breast cancer of about 0.94 compared to women who dont breastfeed.

    You may see:

    • Women who breastfeed have a 6 percent lower risk of breast cancer compared to women who dont breastfeed.

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    Trends In Breast Cancer Deaths

    Breast cancer is the second leading cause of cancer death in women. The chance that a woman will die from breast cancer is about 1 in 39 .

    Since 2007, breast cancer death rates have been steady in women younger than 50, but have continued to decrease in older women. From 2013 to 2018, the death rate went down by 1% per year.

    These decreases are believed to be the result of finding breast cancer earlier through screening and increased awareness, as well as better treatments.

    How Do Doctors Assess Risk For Breast Cancer

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    Theres currently no standardized approach to assessing an individuals breast cancer risk. However, there are several tools that help doctors identify those at a high risk of breast cancer.

    Breast cancer risk assessment tools are heavily based on your personal and family history. However, they do take other factors into account as well. A few examples of commonly used tools include the:

    • Breast Cancer Risk Assessment Tool , also called the Gail model
    • International Breast Cancer Intervention Study risk calculator, also called the Tyrer-Cuzick model
    • Claus model, based off the Cancer and Steroid Hormone Study

    Risk assessment tools provide a variety of measurements. These can include 5-year risk, 10-year risk, and lifetime risk.

    Whats considered high risk can vary by location. In the United States, people with an estimated 5-year risk of 1.67 percent or higher are typically considered high risk.

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    Relative Risk And Therapeutic Management Options For Non Invasive Breast Lesions

    Experienced physicians will assess the relative risk associated with screening indicators, such as age, overall health and personal situation to determine the best follow-up plan.

    If necessary, theraputic interventions may be advised. Usually, if any of the risk factors associated with increased risk ratios are revealed at cancer screening, annual clinical follow-up is considered mandatory.

    However, a lumpectomy or the use of radiation therapy would be unlikely unless a diagnosis of ductal carcinoma in situ is confirmed.

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