Breast Cancer Awareness Month is officially here, and with it comes a flood of new information and updates around the most common cancer among women and the second leading cause of death in the US (behind only heart disease). Here’s a rundown of what’s new.
New rule. Last month, the FDA started enforcing a 2023 rule in the Mammography Quality Standards Act that requires radiology and mammography facilities to notify patients about the density of their breasts.
“If there’s more density, it’s a little bit harder for [clinicians] to find an early-stage breast cancer on the mammogram,” Douglas Feil, chief program officer at the National Breast Cancer Foundation, told Healthcare Brew. “We know that women with higher breast density are more likely to develop breast cancer in their lifetime.”
About 10% of women have extremely dense breasts, according to the CDC, and 40% of women have breasts that are evenly dense throughout. Another 40% of women have breasts that have a few areas of dense tissue, while 10% of women have breasts that are entirely fatty. Women with dense breasts have a higher risk of breast cancer, according to the National Cancer Institute.
The Society of Breast Imaging recommends people with breasts start getting annual mammograms at 40, but says some patients, like those with genetics-based increased risk, should begin preventative screenings as early as 25 years old.
General stats. Every two years, the American Cancer Society (ACS) puts out a report on breast cancer with updates on the state of diagnoses, death rates, and disparities. In its latest report, released on October 1, the organization said that one in eight women in the US will be diagnosed with invasive breast cancer in their lifetime.
In 2024 specifically, the study projected that there will be 310,720 new invasive breast cancer diagnoses among women, and that about 42,250 women are expected to die from the disease. (Some 2,790 men are estimated to be diagnosed this year, with 530 expected deaths.)
Breast cancer incidence is also slowly rising among younger women, according to the report. While the overall breast cancer rate increased 1% annually between 2012 and 2021, the rate increased among women under 50 by 1.4% and among women over 50 by 0.7% each year in that same time period.
Meanwhile, the report said the breast cancer death rate has dropped by 44% since 1989 thanks to advancements in treatment and detection technology. The ACS estimated that this has saved about 517,900 lives.
“That is huge, great news,” Feil said.
Dire disparities. A September study published in the Journal of Clinical Oncology and led by researchers at Mass General Brigham in Boston found significant disparities in breast cancer care and mortality.
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According to the research, Black women with breast cancer are about 40% more likely to die than white women “due, at least in part, to the impact of systemic, institutional, and interpersonal racism on cancer care.”
“Some people have to jump over hurdles just to get access to care,” Feil said. “The barriers could be cost, they could be transportation, childcare. They could also be fear of the healthcare system in general, and lack of trust.”
Researchers analyzed data from 18 studies published between 2009 and 2022. The data included 228,885 breast cancer cases, 34,262 of which were diagnosed among Black women.
“We have to do a better job of being better and building trust with populations,” Feil added.
Breastfeeding possibilities. Two studies published in September from the Dana–Farber Cancer Institute and international researchers found that it’s safe for survivors of breast cancer to breastfeed.
One study, published in the journal Annals of Oncology, reported the results of a collaboration between 78 hospitals and cancer treatment centers around the world. It included data on 474 patients who were younger than 40 between January 2000 and December 2020, had mutations in the cancer-susceptibility genes BRCA1 or BRCA2, had become pregnant after being diagnosed with Stages 1–3 invasive breast cancer, and had delivered a baby.
The patients were divided into two groups: one that breastfed and another that did not. About seven years after the deliveries, researchers found breastfeeding did not impact cancer incidence nor how long patients were cancer-free, as the overall survival rates were the same, which suggests that it’s safe for some patients to breastfeed after breast cancer.
The second study, also an international collaborative work published in the Annals of Oncology, found that patients who temporarily stop endocrine therapy and try to get pregnant can breastfeed safely. The researchers used data from the 2023 POSITIVE clinical trial, which found that younger women who paused breast cancer treatment could have a baby.
“These studies provide the first evidence on the safety of breastfeeding after breast cancer in both young patients carrying BRCA variations that predispose to breast cancer, as well as patients who conceived after pausing endocrine therapy,” Ann Partridge, an oncologist at Dana–Farber and co-senior investigator on the study, said in a press release. “Our findings emphasize the possibility of supporting maternal and infant needs without compromising maternal safety.”