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Breast Cancer Incidence
in the U.S. and the World
Julia Mota
Northern Arizona University
Abstract
Breast cancer is a non-infectious disease that is prevalent in the United
States and the world. It is a disease that is the leading cause of death for
women around the globe (American Cancer Society, 2011). When examining
cancer death overall, death from breast cancer is second only to lung cancer
in the United States (Breastcancer.org, 2016). The research for this writing
paper focuses on the epidemiological aspects of breast cancer. Topics that
are discussed include the disease processes that lead up to a diagnosis of
breast cancer, the symptoms that preclude clinical staging, definitions of
stages 0 through IV of both non-invasive and invasive breast cancer, breast
cancer prognosis factors, epidemiological measurements and data (including
the Surveillance, Epidemiology, and End Results Program or “SEER”, the
Cancer Intervention and Surveillance Modeling Network also known as
“CISNET”, and population-based cancer registries such as the National
Central Cancer Registry of China) that have been used to observe, report
and follow how rates of diagnosis, stages, and prognoses in the United
States compare regionally and around the world.

Part 1: Person, Place, Time Inside
the U.S. – Breast Cancer

Breast cancer is a condition involving the uncontrolled overgrowth of
cells, and is considered a non-infectious disease process. There is a
defect in the genes that are responsible for regulating the normal cell
cycle; this abnormality is also referred to as a mutation. Breast cancer
can affect many areas within and on the breast surface. Types of breast
cancer include common forms such as: ductal carcinoma in situ (DCIS),
invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC),
recurrent breast cancer, and metastatic breast cancer. Less common
forms include male breast cancer and inflammatory breast cancer
(IBC). Approximately 1% of men in the United States are diagnosed
with breast cancer; a worse prognosis in cases of metastatic or
advanced disease in evident when compared to women (Dragun, 2013).
Inflammatory breast cancer is associated with a poor prognosis, only
32-42 percent of cases survive 3 years after diagnosis (Gargiullo,
Jamison, & Wingo, 2004). It is possible for a person to have one, or a
combination of breast cancer types at the same time and in the same
breast. In addition, breast cancer can be found to be hormone
(estrogen and progesterone) receptor positive (commonly referred to
ER/PR positive or negative), and can also include proteins that test
positive for human epidermal growth receptor 2 (HER2). This protein
accounts for about 20% of breast cancer cases and often accounts for
more aggressive and fast-growing tumors (Breastcancer.org, 2016).
Part 1: Person, Place, Time Inside
the U.S. – Breast Cancer (cont.)

The failure of the normal cell cycle, particularity the normal
process of cell death (apoptosis) results in tumor
formation. These tumors can be either benign (nonmalignant) or malignant (cancerous). Benign tumor cells
appear normal under the microscope, and these tumors do
not invade normal surrounding tissues. Malignant tumors
are considered cancerous and if left untreated, may result
in the invasion of nearby tissues and organs (metastases).
It is the spread of these malignant cells that can ultimately
result in death from the disease (Breastcancer.org, 2016).
Part 1: Person, Place, Time Inside the
U.S. – Disease condition specifics
There are several well-documented and established risk
factors for breast cancer. These risk factors include: age, gender
(female), family history (a person’s risk is doubled with a firstdegree relative), genetics, personal history of breast cancer,
radiation to chest or face prior to the age of 30, certain benign
breast conditions, ethnicity/race (white women have the highest
risk of developing breast cancer, but African-American women have
a higher chance of developing more aggressive forms at a younger
age), being overweight, pregnancy history (not having a full-term
pregnancy by the age of 30, breastfeeding history, menstrual age,
use of Hormone Replacement Therapy, alcohol use, having dense
breast tissue, lack of exercise, and smoking (Breastcancer.org,
2016).

Part 1: Person, Place, Time Inside the U.S. –
Disease condition specifics (cont.)

Monthly breast self-exams are recommended for all women and
yearly mammograms for women over the age of 40 years old. If
someone is determined to have a higher than usual risk, they
may be advised to start getting mammograms and other types of
imaging (such as ultrasound and Magnetic Resonance Imaging)
earlier than 40 years old (Breastcancer.org, 2016).
(image retrieved from https://jeffreysterlingmd.com/2015/10/12/straight-no-chaser-how-to-perform-the-breast-selfexam-3/)
Part 1: Person, Place, Time Inside the U.S. –
Disease condition specifics (cont.)
Breast cancer is described in stages 0 through IV. Stage 0
describes non-invasive cancers that are contained to their original
location, and Stage IV is when cancer cells have spread outside of
the original area and local region to other parts of the body. Within
the stages are further classifications indicated precise information
(such as tumor size and extent of lymph node involvement), for
example, Stage IIA, IIB, etc. The four characteristics of breast
cancer staging is size of tumor, whether or not the cancer is
invasive, lymph node involvement, and if the cancer has spread
outside the breast. An additional staging system, called “TNM” may
be used as well; this stands for (T) tumor, (N) lymph node
involvement, and (M) metastasis to other parts of the body
(Breastcancer.org, 2016).

Part 1: Person, Place, Time Inside the U.S. –
Disease condition specifics (cont.)

Breast cancer prognosis is generally associated with early
detection. Death rates have been decreasing since 1989,
especially in women under 50 years old at time of diagnosis. This
progress can be attributed to advances in treatment, detection
methods (increasing chances of early detection in commonly
screened age groups), and increased awareness
(Breastcancer.org, 2016).
(image retrieved from https://www.pinterest.com/pin/293226625708785933/)
Part 1: Person, Place, Time Inside the U.S. –
Disease condition specifics (cont.)
Currently, active breast cancer treatments consist of
surgical intervention, chemotherapy, and radiation treatments. The
order of treatment phases can vary person to person and be
determined by different variables (factors include size and location
of tumor or tumors and type of breast cancer). Many women who
undergo breast cancer treatment need to stay on hormone therapy
for 5-10 years. Some up and coming treatments that have been
shown to be promising are innovation in targeted therapies and
immunotherapy (Breastcancer.org, 2016).

Part 1: Person, Place, Time Inside the U.S. –
Data and Measures Used
Three types of epidemiological methods that are
used to track and report breast cancer include: the
Surveillance, Epidemiology, and End Results Program or
“SEER” (Burnside, Sprague, & Trentham-Dietz, 2010),
simulation models from the Cancer Intervention and
Surveillance Modeling Network or “CISNET” (AdamsCampbell, et al., 2012), and Incidence and mortality
data collected from population-based cancer registries
such as the National Central Cancer Registry of China
(Chen, He, Zeng, Zhang, & Zheng, 2012)

Part 1: Person, Place, Time Inside the U.S. –
Data and Measures Used (cont.)
Worldwide breast cancer incidence: 1,383,500 (American
Cancer Society, 2011).

Worldwide breast cancer prevalence 1.4 million (American
Cancer Society, 2011).

Worldwide breast cancer mortality rate: 458,400 (American
Cancer Society, 2011). Breast cancer is the leading cause of cancer
deaths among women between the ages of 20-59 worldwide (World
Health Organization, 2011).

(image retrieved from
http://americannewsreport.com/american-cancer-society-says-maps-of-cancer-deaths-by-district-shows-big-variation8822175)
Part 1: Person, Place, Time Inside the U.S. –
Patterns of Disease in the United States
Breast cancer incidence and prevalence rates are higher
in North America than in many other areas of the world
(Bray, McCarron, & Parkin, 2004), (World Health
Organization, 2011). Some of the reasons attributed to this
finding are attributed to the Western diet.

It is estimated that approximately 1 in 8 U.S. women will
develop breast cancer in their lifetime (12% risk). 61,000 cases of
non-invasive breast cancer occurred in the U.S., alongside 246,000
new cases of invasive breast cancers (American Cancer Society,
2011).

Part 1: Person, Place, Time Inside the U.S. –
Patterns of Disease in the United States (cont.)
Men have an approximate risk of 1 in 1,000 to have a
diagnosis of breast cancer in their lifetime. 2,600 cases of male
breast cancer are expected to be diagnosed in 2016
(Breastcancer.org, 2016).

U.S. breast cancer cases are more common in AfricanAmerican women than in White, Asian, Hispanic, and NativeAmerican women (especially the more aggressive forms of breast
cancer) and tend to be diagnosed earlier (under 45 years of age).
African-American women are more likely to die from breast cancer
(Breastcancer.org, 2016).

Part 1: Person, Place, Time Inside the U.S. –
Patterns of Disease in the United States
(cont.)
Of the projected 246,000 estimated new cases of breast cancer in
the U.S., 13,110 of these cases will occur in women under the age
of 40. Every year, 70,000 women and men under the age of 40
years old are diagnosed. Breast cancer is the most common cancer
for women between 15-39 years of age. And, of these cases, about
1,200 women under the age of 40 will die of breast cancer (Young
Survivor Coalition, 2016).

There are 2.8 million women presently in the U.S. who have been
treated for breast cancer; this figure includes women currently in
active treatment and those who have finished treatment
(Breastcancer.org, 2016).

Part 2: Person, Place, Time Outside the U.S.
– Patterns of Disease in the United States

As of 2012, breast cancer prevalence in the European Union was
reported at 362,000 people, with a 5-year prevalence of
1,444,000 people (World Health Organization, 2012).

As of 2007, breast cancer incidence in China (165,171 people)
was 7.82% of newly diagnosed cancer cases for men (92,266
men) and women (72,905 women), but equated to 17.53% when
isolated to women only (Chen, He, Zeng, Zhang, & Zheng, 2012).

Women of Black African and Black Caribbean ethnicity are found,
according to 2015 UK data, are more likely to have late-stage
diagnoses of breast cancer and lower rates of survival as
compared to White British women. This was attributed to barriers
in education facilitated by cultural taboos and stereotypes and
challenges getting access to prevention services (Davies, et al.,
2015).
Part 2: Person, Place, Time Outside the U.S. –
Patterns of Disease in the United States (cont.)
In France and Sweden, notable decreases in breast cancer
prevalence was found throughout 2007, but only for women
between the ages of 55-64 (in France) and ages 50-59 (in Sweden).
This data also correlated with a decrease in the use of Hormone
Replacement Therapy (Allemand, Ricordeau, Seradour, & Weill,
2010).

Japanese women who live in Japan were found in 2007 to have a
risk to develop breast cancer three times lower (32.5 out of
100,000 women) than Japanese women who lived in Hawaii (99.5
out of 100,000 women) (Gram, Maskarinec, Nagata, & Pagano,
2007).

Part 2: Person, Place, Time Outside the U.S.
– Patterns of Disease in the United States
(cont.)
The prevalence rate of breast cancer in more developed regions
was documented at 794,000 cases, and 883,000 in less developed
regions. The most notable difference was that more women die of
breast cancer in less developed regions when compared to the rates
in more developed regions (324,000 deaths versus 198,000 deaths)
(World Health Organization, 2012).

(image retrieved from http://www.who.int/en/)
Part 2: Person, Place, Time Outside the U.S.
– Patterns of Disease in the United States
(cont.)
Statistically, breast cancer continues to be the mostfrequent cancer that affects women around the world. There
is currently debate in regard to the role that nutrition plays in
the development and prevention of breast cancer. Diets high
in certain items like red meat, processed food, and dairy
products are thought to possibly increase risk. Other
environment factors that are discussed are exposure to
pesticides/insecticides, cell phone radiation, and geneticallymodified food (GMOs) to name a few.

Summary & Conclusion
In summary, breast cancer is a devastating disease
that continues to rank as a cancer with high prevalence
and mortality rates of women worldwide. In 2012, the
total of deaths in the United States from breast cancer
was documented at 617,000 women and men. Also, the
numbers of new cases worldwide was at 14.1 million.
Improvements in early detection methods and
recommendations, along with treatment advancements
have improved outcomes for many people affected by
breast cancer. There are an estimated 32.6 million
people living with a breast cancer diagnosis (either past
or present), almost 5 million of those survivors are in
the United States today (World Health Organization,
2012).

Summary & Conclusion
(images retrieved from
http://www.slideshare.net/rebeccamclarkey/breast-cancer-awareness-conversation-starters-series-byistudentnursehttp://blog.bfmkaufman.com/2015/09/the-importance-of-finding-breast-cancer-early/)
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