Breast Cancer

2018 ◽  
Author(s):  
Nancy E Davidson

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 266,120 In 2018, along with 63,960 new cases of non-invasive (in situ) breast cancer. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.

2017 ◽  
Author(s):  
Nancy E Davidson

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 235,000 women in this country in 2013 and is expected to result in approximately 40,000 deaths. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.


2018 ◽  
Author(s):  
Nancy E Davidson

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 235,000 women in this country in 2013 and is expected to result in approximately 40,000 deaths. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1533-1533
Author(s):  
P. Ravdin ◽  
K. A. Cronin ◽  
N. Howlader ◽  
C. D. Berg ◽  
E. J. Feuer ◽  
...  

1533 Background: We have recently reported that a steep decrease in the incidence of breast cancer occurred in the United States in 2003 relative to 2002 (BCRT 100: S5, 2006). This decrease was most evident in patients older than 50, and largely occurred because of a decrease in the incidence of estrogen receptor positive breast cancer. This decrease occurred after the report in 2002 of the results of first of the Women s Health Initiative trials of postmenopausal hormone therapy (HT). This publication showed that use of a combined estrogen/progestin combination was associated with increased risk of breast cancer and heart disease and led to an immediate and substantial decrease in the use of HT in the US. Dramatic shifts in breast cancer incidence are unusual, and provide unique opportunities to test models that have been developed to explain trends in breast cancer incidence and mortality. We have been engaged in modeling trends in breast cancer incidence and mortality, in collaborative effects such as the Cancer Intervention and Surveillance Modeling Network (CISNET), to understand these and other processes (NEJM 353:1784–1792,2005). These models have practical implications for understanding the impact of changes in risk factors, use of prevention strategies, screening, and treatment of breast cancer. Methods: SEER public use incidence data from 1990 to the end of 2003 will be updated with information from the release in the spring of 2007 of incidence data for 2004. We will analyze the full data set through 2004 and report on the trends in incidence of breast cancer in the population as a whole and by subsets (such as age, estrogen receptor status, stage etc). We will also use the most recent and detailed data about HT use and screening mammography during this period as part of modeling. Results: We are awaiting SEER data from 2004 which will be released by April of 2007. Conclusions: Our first SEER based multi-year analysis of breast cancer incidence following the change in HT use in the US will be presented. Modeling of these trends in incidence will be discussed in the context of understanding the role of various contributors to the change in breast cancer incidence and what insights on the evolution of preclinical disease might be possible. No significant financial relationships to disclose.


2003 ◽  
Vol 21 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Christopher I. Li ◽  
Janet R. Daling ◽  
Kathleen E. Malone

Purpose: Between 1987 and 1998, breast cancer incidence rates rose 0.5%/yr in the United States. A question of potential etiologic and clinical importance is whether the hormone receptor status of breast tumors is also changing over time. This is because hormone receptor status may reflect different etiologic pathways and is useful in predicting response to adjuvant therapy and prognosis. Methods: Age-adjusted, age-specific breast cancer incidence rates by estrogen receptor (ER) and progesterone receptor (PR) status from 1992 to 1998 were obtained and compared from 11 population-based cancer registries in the United States that participate in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Results: From 1992 to1998, the overall proportion of breast cancers that were ER-positive and PR-positive increased from 75.4% to 77.5% (P = .0002) and from 65.0% to 67.7% (P < .0001), respectively, continuing trends observed before 1992. These increases were limited to women 40 to 69 years of age. The proportions of ER-positive/PR-positive tumors increased from 56.7% to 62.3% (P = .0010) among 40- to 49-year-olds, from 58.0% to 63.2% (P = .0002) among 50- to 59-year-olds, and from 63.2% to 67.9% (P = .0020) among 60- to 69-year-olds. Conclusion: From 1992 to 1998, the proportion of tumors that are hormone receptor–positive rose as the proportion of hormone receptor–negative tumors declined. Because the incidence rates of hormone receptor–negative tumors remained fairly constant over these years, the overall rise in breast cancer incidence rates in the United States seems to be primarily a result of the increase in the incidence of hormone receptor–positive tumors. Hormonal factors may account for this trend.


Author(s):  
Mary C. White ◽  
Marion (Mhel) H. E. Kavanaugh-Lynch ◽  
Shauntay Davis-Patterson ◽  
Nancy Buermeyer

Advances in breast cancer science, early detection, and treatment have resulted in improvements in breast cancer survival but not in breast cancer incidence. After skin cancer, breast cancer is the most common cancer diagnosis in the United States. Each year, nearly a quarter million U.S. women receive a breast cancer diagnosis, and the number continues to rise each year with the growth in the population of older women. Although much remains to be understood about breast cancer origins and prevention, action can be taken on the existing scientific knowledge to address the systemic factors that drive breast cancer risk at the population level. The California Breast Cancer Research Program funded a team at Breast Cancer Prevention Partners (BCPP) to convene leaders in advocacy, policy, and research related to breast cancer prevention from across the state of California. The objective was the development of a strategic plan to direct collective efforts toward specific and measurable objectives to reduce the incidence of breast cancer. The structured, innovative approach used by BCPP to integrate scientific evidence with community perspectives provides a model for other states to consider, to potentially change the future trajectory of breast cancer incidence in the United States.


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