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REPORT TO THE NATION
BREAST CANCER 2010
www.nbocc.org.au
© National Breast and Ovarian Cancer Centre 2010.
Funded by Australian Government Department of Health and Ageing
This report provides an overview of current knowledge about breast cancer in Australia.
It includes the most up-to-date information on incidence, mortality and survival for
invasive breast cancer in women, using the latest available data.1
About National Breast and Ovarian Cancer Centre
Funded by the Australian Government, National Breast and Ovarian Cancer Centre
(NBOCC) works in partnership with health professionals, cancer organisations,
researchers, governments and people diagnosed, to improve outcomes in breast and
ovarian cancer. NBOCC plays a vital role in the translation of worldwide cancer research
into meaningful and evidence-based information to guide the work of Australian health
professionals, inform policy, improve health service delivery, inform patients with breast
or ovarian cancer about all aspects of their diagnosis and treatment, and raise
community awareness about the diseases.
What is breast cancer?
Breasts are made up of lobules and ducts surrounded by fatty and connective tissue.
Breast cancer occurs when cells in the ducts or lobules grow abnormally and multiply.
The abnormal cells form growths called cancers. Non-invasive breast cancer is when the
cancer cells remain in the ducts and lobules of the breast and have not spread. Invasive
breast cancer is when the cancer cells spread beyond the ducts and lobules into the
surrounding tissue.
Did you know?

Breast cancer is the most commonly diagnosed cancer among women in Australia.

Around 14,000 women will be diagnosed with invasive breast cancer in 2010.

One in nine women will be diagnosed with breast cancer in their lifetime.

Almost 2,700 women died from breast cancer in 2007.2

Eighty-eight out of every 100 women diagnosed with breast cancer survive five or
more years beyond their diagnosis.

Breast cancer is the most common cancer affecting Aboriginal and Torres Strait
Islander women.

Breast cancer is uncommon in men and accounts for less than one per cent of all
breast cancer cases.
All data are from the Australian Institute of Health and Welfare & National Breast and Ovarian Cancer Centre
Breast cancer in Australia: an overview, 2009 report, unless otherwise specified.
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2
Illustration of a woman's breast showing invasive breast cancer and ductal
carcinoma in situ
There are different types of breast cancer based on the extent of the disease.
Ductal carcinoma in situ (DCIS)
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer that is contained within
the milk ducts at diagnosis. Almost 1,600 women were diagnosed with DCIS in Australia
in 2005 and the incidence rate of DCIS (number of women diagnosed with DCIS per
100,000 women) increased between 1995 and 2005.3 The incidence rate is highest for
women aged 60-69 years.3
3
Incidence of DCIS in Australian women, 1995-2005
As DCIS is a non-invasive breast cancer, women cannot die from DCIS. However, women
diagnosed with DCIS are about four times more likely to develop a subsequent invasive
breast cancer compared with other women of similar age in Australia. Women diagnosed
with DCIS have about a 10 per cent chance of being diagnosed with a subsequent
invasive breast cancer within 10 years of DCIS diagnosis.3
Early breast cancer
Early breast cancer is cancer that is contained in the breast (localised) and may or may
not have spread to the lymph nodes in the breast or armpit (regional). Women with early
breast cancer have no detectable spread outside the breast and armpit area.
The majority of breast cancer cases are diagnosed when the breast cancer is still
localised. Of those diagnosed with localised breast cancer, the five-year relative survival
is 97 per cent. This means 97 out of 100 people diagnosed with localised breast cancer
will survive five or more years following their breast cancer diagnosis (NSW data 19992003).
Secondary breast cancer
Sometimes breast cancer cells travel in the bloodstream or lymphatic system to other
parts of the body. This is secondary breast cancer (also called metastatic or advanced
breast cancer). The most common places that breast cancer spreads to are the bones,
liver, lungs and brain.
Around four per cent of breast cancer cases are diagnosed when the breast cancer has
spread outside the breast to distant organs (NSW data 1995-2004). Approximately 7,000
Australian women are estimated to be alive today with secondary breast cancer. About a
third of these women are estimated to have been diagnosed 10 or more years ago.
Note - Relative survival compares the survival of a group of women with breast cancer to the expected survival
of similar-aged women in the general population.
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The five-year relative survival for those diagnosed with secondary (distant) breast cancer
is 41 per cent (NSW data 1999-2003).
Invasive breast cancer in women
The following information about breast cancer relates to all invasive breast cancers (i.e.
early and secondary) in women.
Incidence

Breast cancer is the most commonly diagnosed cancer among women in Australia.

Around 14,000 women will be diagnosed with breast cancer in 2010.

On average, 38 women will be diagnosed with breast cancer each day in 2010.
Five most commonly diagnosed cancers in Australian women, 2006
Increasing age is one of the strongest risk factors for developing breast cancer. Breast
cancer can occur in younger women, with around 700 women under 40 years diagnosed
annually. However, about three out of four breast cancer cases occur in women aged 50
years and older.
5
Age at diagnosis of breast cancer in Australian women, 2006
It is anticipated that the number of women diagnosed with breast cancer each year will
continue to increase due to the growing and ageing population. By the year 2015, 15,409
women are projected to be diagnosed annually with breast cancer in Australia,
representing a 22 per cent increase compared with 2006.
Number of women diagnosed with breast cancer, observed for 1982-2006,
projected for 2007-2015
Over the last 25 years the incidence rate of invasive breast cancer (number diagnosed
per 100,000 women) has increased for women in all age groups, except for younger
women aged under 40 years. Over this time, the incidence rate for younger women has
remained stable with between 11 and 13 women diagnosed with breast cancer per
100,000 women. However, the incidence rate for women aged 50-69 years has increased
from 174 to 288 women diagnosed with breast cancer per 100,000 women over the
same period of time.
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Women living in areas with the highest socioeconomic status have a significantly higher
incidence rate of breast cancer compared with women living in other areas. This may be
related, at least in part, to lifestyle factors.
Around 30 per cent of women diagnosed with breast cancer live outside a major city.
Women living in major cities at the time of breast cancer diagnosis have a significantly
higher incidence rate of breast cancer than those in more remote areas.
Incidence of breast cancer by remoteness in Australian women, 2002-2006
Mortality

On average, seven women die from breast cancer every day in Australia.

Breast cancer was the second most common cause of cancer death in women in
2007.2

Almost 2,700 women died from breast cancer in 2007.2

Breast cancer accounts for one in every 25 deaths in women from any cause.
Note - Age-standardised rates take into account differences in the age distribution of the population over time.
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Five most common types of cancer death in Australian women, 2007 2
Note - Unknown primary site refers to cancer that has spread to other parts of the body and the
original/primary cancer site is not known.
While the incidence rate of breast cancer increased between 1982 and 2006, the
mortality rate dropped over the same period.
Rates of incidence and mortality from breast cancer in Australian women, 19822006
Note - Age-standardised rates take into account differences in the age distribution of the population over time.
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Burden of disease

Breast cancer was the leading cause of disease burden due to cancer in women in
2003.

Breast cancer was the leading cause of potential years of life lost in women in
2007.4
Burden of disease combines information about women who die prematurely (the number
of years of life lost due to disease) and the number of 'healthy' years of life lost due to
disease, disability or injury.
Breast cancer is responsible for almost the same burden of disease as the next two
leading cancer contributors together (i.e. lung and bowel cancer).
Leading cancer-related causes of burden of disease in Australian women, 2003
Disability-adjusted life years (DALYs) are the sum of the years of life lost due to
premature mortality (YLL) in the population and the equivalent years of 'healthy' life lost
due to disability (YLD) for all new cases.
Survival

Eighty-eight out of every 100 women with breast cancer survive five or more
years following their breast cancer diagnosis.
Survival figures provide information on the likelihood that a woman will still be alive at a
specified point in time (such as five years) following a diagnosis of breast cancer.
Women diagnosed with breast cancer are now surviving significantly longer than ever
before. Out of every 100 women diagnosed with invasive breast cancer 25 years ago,
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only 73 women were alive five years later. Today 88 out of every 100 women are alive
five years after a diagnosis of breast cancer.
Five-year relative survival for Australian women with breast cancer by period of
diagnosis
1982-1987
2000-2006
Note – Relative survival compares the survival of a group of women with breast cancer to the expected survival
of similar-aged women in the general population.
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Improvements in survival are attributed to earlier detection of breast cancer through
population-based mammography screening and improved treatments for breast cancer.
Survival is even higher for those diagnosed with very early breast cancer.
Early detection of breast cancer
Breast awareness
Finding breast cancer early increases the chance of surviving the disease.
Women diagnosed with smaller tumours have considerably higher survival rates than
women diagnosed with larger tumours. The five-year relative survival for women with
smaller tumours at diagnosis (≤10mm) was 98 per cent compared with 73 per cent for
women with larger tumours (≥30mm).
Five-year relative survival to 2006 by size of cancer for Australian women
diagnosed in 1997
Screening mammography
Screening mammograms are for women who do not have any symptoms or breast
changes. BreastScreen Australia is a national population-based mammography screening
program established to reduce mortality and morbidity from female breast cancer
through early detection. It provides screening mammograms free of charge to women
aged 50-69 years, with women aged 40-49 years and 70 years and over also being
eligible.
Population-based screening using mammography is the best early detection method
available for reducing deaths from breast cancer. No other technology has been
demonstrated to reduce breast cancer mortality in the breast cancer screening setting.
Note – Relative survival compares the survival of a group of women with breast cancer to the expected survival
of similar-aged women in the general population.
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Evidence of the benefit of screening mammography is strongest for women aged 50-69
years. There is evidence that screening mammography is less effective for women aged
40-49 years. Screening becomes more effective as women move through their forties.
There is no evidence that population-based screening mammography is beneficial for
women younger than 40 years.
Currently around 56 per cent of women in the target age group (aged 50-69 years)
participate in biennial screening through BreastScreen Australia. This level of
participation is associated with an approximate 21-28 per cent reduction in breast cancer
mortality.5 Increasing participation in the target age group would lead to even greater
mortality benefits, and it is predicted that a participation rate of 100 per cent in the
target age group would reduce breast cancer mortality by approximately 34-45 per cent.5
Over 1.6 million women participated in BreastScreen Australia in 2007-2008. The rate of
detection of invasive breast cancer increased between 1996 and 2008. Importantly,
nearly two-thirds of all invasive breast cancers detected by BreastScreen Australia were
small (≤15mm).6
Breast cancer in Aboriginal and Torres Strait
Islander women

Breast cancer is the most common cancer affecting Aboriginal and Torres Strait
Islander women.
Aboriginal and Torres Strait Islander women are significantly less likely than nonIndigenous women to be diagnosed with breast cancer. However, Aboriginal and Torres
Strait Islander women have a lower five-year crude survival than non-Indigenous women
following a diagnosis of breast cancer.
Five-year crude survival for women, NT, QLD and WA, 2002-2006
Note - Crude survival is the proportion of women alive at a specified point in time (e.g. five years) after a
diagnosis of breast cancer.
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Breast cancer in men

One hundred and two men were diagnosed with invasive breast cancer in 2006.

Twenty-six men died from breast cancer in 2007.2
Since men also have breast tissue, they can develop breast cancer. However, breast
cancer is uncommon in men and accounts for less than one per cent of all breast cancer
cases.
This is because the male breast ducts are less developed than female breast ducts and
the male breast cells are not constantly exposed to the tumour-promoting effects of
female hormones.
See www.nbocc.org.au/men for more information.
Risk factors for breast cancer
Generally it is not possible to determine what causes breast cancer in an individual.
Research suggests that breast cancer occurs as a consequence of combinations of
individual factors and events.7
Known risk factors
Having certain risk factors increases the chance of developing breast cancer but does not
mean an individual will definitely develop breast cancer. Some of the risk factors for
breast cancer are beyond individual control but there are some factors that can be
changed.

Gender: being a woman is the strongest risk factor for breast cancer.

Age: increasing age is one of the strongest risk factors for breast cancer.

Affluence: breast cancer occurs more frequently in affluent and western
populations.

Family history of breast cancer: family history is important on both sides of
the family. The risk of breast cancer increases with the closeness of the relative
diagnosed with breast cancer (i.e. first degree, second degree), the number of
relatives diagnosed and when relatives are diagnosed at a young age.

Breast conditions: women diagnosed with invasive breast cancer have an
increased risk of developing cancer in the other breast. Dense breast tissue on
mammography is also emerging as a strong risk factor for breast cancer.

Endogenous (naturally occurring) oestrogens: postmenopausal women with
high levels of circulating oestrogens have an increased risk.

Hormonal factors: hormonal factors that increase breast cancer risk include
older age at menopause (over 55 years), use of combined hormone replacement
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therapy, use of the oral contraceptive pill and younger age at commencement of
menstruation (under 12 years).

Personal and lifestyle factors: a number of personal and lifestyle factors are
associated with increased risk of breast cancer. These include alcohol consumption
and overweight and obesity for postmenopausal women.
Protective factors
Unproven factors
While it is not known how to prevent
breast cancer, there are some factors that
may reduce the risk of breast cancer.
For a number of factors, there is no
evidence to support an association with
risk of breast cancer.

Parity: giving birth to at least one
child.


Earlier age at first birth: giving birth 
before age 30.

Breastfeeding: breastfeeding for at
least 12 months in total.




Number of births: giving birth to
four or more children compared to
one child.
Physical activity: exercising for two
or more hours per week.
Miscarriage or termination of
pregnancy.
Environmental pollutants.
Wearing a bra or different types of
bra.
Silicone implants.

Use of underarm deodorant or
antiperspirant.

Stress.
See NBOCC's Breast cancer risk factors: a review of the evidence for more information
about specific breast cancer risk factors or visit www.nbocc.org.au/risk to calculate your
breast cancer risk.
Research into breast cancer
The key bodies funding and conducting breast cancer research in Australia are listed
below.
National Health and Medical Research Council (NHMRC)
During 2004 to 2009, NHMRC contributed over $80 million to breast cancer research in
Australia.
Some areas of breast cancer research currently funded by NHMRC are:

identifying genes that control the spread of breast cancer

inhibiting breast cancer growth in bones

breast cancer prevention medications

occupational causes of breast cancer, particularly shift work

green tea and cancer prevention

measuring unwanted radiation dose outside of the radiotherapy treatment field.
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National Breast Cancer Foundation (NBCF)
Since its inception, NBCF has allocated more than $55 million for research across the
broader domains of breast cancer research (e.g. genetics, treatment, support and
palliative care for women).
NBCF awarded 25 grants in 2010 for research projects including:

preventing breast cancer in BRCA1 and BRCA2 mutation carriers

identification of breast cancer genes through targeted next generation sequencing

target activated therapies: a new strategy for monitoring and treating breast
cancer

the impact of treatment-focused genetic testing in patients newly diagnosed with
breast cancer

optimising imaging surveillance for women in complete remission after primary
treatment for breast cancer

targeting breast cancer recurrence through epithelial mesenchymal plasticity (a
newly recognised process in the spread of cancer that fosters cell movement)

trialling new approaches to shared care for follow-up of women after early breast
cancer (NBOCC project).
Australian New Zealand Breast Cancer Trials Group (ANZ
BCTG)
The ANZ BCTG was established in 1978 to support collaborative national and
international clinical trials into breast cancer. The ANZ BCTG clinical trials program
involves over 50 studies in various stages of recruitment, follow-up, analysis and
publication. Some current clinical trials are:

IBIS-II: an international multi-centre trial of breast cancer prevention medications
in postmenopausal women at increased risk of breast cancer or with hormone
sensitive DCIS

ALTTO: a randomised multi-centre trial of adjuvant therapies, their sequence and
their combinations in patients with HER2-positive early breast cancer

TRIO-012: a randomised multi-centre, multi-national trial of therapies in
previously untreated patients with HER2-negative, unremovable, locally recurrent
or metastatic breast cancer.
Cancer Australia
Cancer Australia is a national government agency, established in 2006, to improve
outcomes for all people affected by cancer. Cancer Australia has developed the Prioritydriven Collaborative Cancer Research Scheme to support research that reduces the
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impact of cancer on the community. Some successful applicants in 2009 proposed
research studies to investigate:

identifying margins with a PET (positron emission tomography) probe in DCIS and
invasive breast cancer

the experiences and psychosocial needs of young children who have a mother
with breast cancer

building better bras for women living with a diagnosis of breast cancer

investigating the role of microRNAs (small regulatory molecules) in the
progression of DCIS to invasive breast cancer.
Who's who in breast cancer
These key national breast cancer organisations work separately and together to improve
breast cancer outcomes.
Logo
Description

National authority, funded by the Australian Government.

Ensuring the latest evidence guides health professionals
in the delivery of care.

Informing patients and the community about all aspects
of the disease.

Improving survival through information and education.
www.nbocc.org.au

Linking together women with breast cancer.

Supporting and informing women and families.

National advocacy leader.
www.bcna.org.au

Raising funds for research into prevention and cure.

Advocating for breast cancer research.

Providing opportunities for all Australians to participate in
research.
www.nbcf.org.au

Recruiting and training McGrath Breast Care Nurses in
communities right across Australia.

Educating young women to be breast aware.
www.mcgrathfoundation.com.au
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Resources
NBOCC has developed evidence-based resources for consumers and health professionals
about breast cancer. These are available for download or to order from NBOCC's website:
www.nbocc.org.au or call 1800 624 973. Some relevant resources are listed below.
Resources for patients and their families
Breast cancer in men
Cancer - how are you travelling?
Ductal carcinoma in situ – understanding your diagnosis and treatment
Guide for women with early breast cancer
Guide for women with secondary breast cancer
When the woman you love has early breast cancer
When the woman you love has secondary breast cancer
Resources for health professionals
Breast cancer risk factors: a review of the evidence
Clinical practice guidelines for the management of early breast cancer
Clinical practice guidelines for the management of advanced breast cancer
Clinical practice guidelines for the psychosocial care of adults with cancer
The investigation of a new breast symptom – A guide for GPs
References
All data are from the Australian Institute of Health and Welfare & National Breast and
Ovarian Cancer Centre Breast cancer in Australia: an overview, 2009 report, unless
otherwise specified.
1.
Australian Institute of Health and Welfare & National Breast and Ovarian Cancer
Centre. Breast cancer in Australia: an overview, 2009. Cancer series no. 50. Cat.
no. CAN 46. Canberra: AIHW, 2009.
2.
Australian Institute of Health and Welfare. ACIM (Australian Cancer Incidence and
Mortality) Books. Canberra: AIHW, 2010.
3.
Australian Institute of Health and Welfare & National Breast and Ovarian Cancer
Centre. Risk of invasive breast cancer in women diagnosed with ductal carcinoma
in situ in Australia between 1995 and 2005. Cancer series no. 51. Cat. no. CAN
47. Canberra: AIHW, 2010.
17
4.
Australian Institute of Health and Welfare. Australia's health 2010. Australia's
health series no. 12. Cat. no. AUS 122. Canberra: AIHW, 2010.
5.
Commonwealth of Australia. Evaluation of the BreastScreen Australia Program Evaluation Final Report - June 2009. Canberra: Commonwealth of Australia, 2009.
6.
Australian Institute of Health and Welfare. BreastScreen Australia monitoring
report 2006-2007 and 2007-2008. Cancer series no. 55. Cat. no. CAN 51.
Canberra: AIHW, 2010.
7.
National Breast and Ovarian Cancer Centre. Breast cancer risk factors: a review of
the evidence. Surry Hills: National Breast and Ovarian Cancer Centre, 2009.
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