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Gupta: Progress, hurdles in breast cancer fight

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(CNN) -- In 1987, around one in four women age 50 and older said they'd had a mammogram and breast exam in the past two years. Eleven years later, that number jumped to 69 percent.

Despite that progress, breast cancer today remains the most frequently diagnosed cancer among women in the United States, except for skin cancer.

As part of National Breast Cancer Awareness Month, CNN's Dr. Sanjay Gupta sheds some light on the successes and obstacles in the fight, along with debunking some common breast cancer myths.

Q: What progress has been made over the decades in the fight against breast cancer?

A: The decline in breast cancer death rates since 1990 has been attributed to improvements in treatment and to early detection. But, while utilization of mammography has been increasing, women below the poverty level are still less likely to have had a mammogram within the past two years than women at or above the poverty level. We need to do a better job of reaching out to the poor and the uninsured to make sure they have access to early detection and the best treatments.

Q: What are some other areas of advancement?

A: In a September report, the American Cancer Society announced:

  • Progress in early detection and treatment of breast cancer continues to result in a slow, steady drop in mortality rates, a trend that started in 1990. The latest figures show the death rate from breast cancer dropped by 2.3 percent a year since 1990, with the drop most evident in younger women.
  • Between 1987 and 2002, incidence rates increased by 0.3 percent per year overall, with the increase limited to women age 50 and older. Rates actually declined among women 40 to 49, and there has been little change among women under 40 during that same time period.
  • The death rate from breast cancer in women decreased by 2.3 percent per year between 1990 and 2002. Death rates decreased by 3.3 percent per year among women younger than 50, and by 2 percent per year among women 50 and older.
  • Q: What about risk factors? Are some people more likely to be diagnosed with breast cancer?

    A: We do not yet know exactly what causes breast cancer, but we do know that certain risk factors are linked to the disease. A risk factor is anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, can be controlled. Others, like a person's age or family history, can't be changed. But having a risk factor, or even several, doesn't mean that a person will get the disease. Some women who have one or more risk factors never get breast cancer. And most women who do get breast cancer don't have any risk factors.

    Q: What effect do birth control pills have on breast cancer risk?

    A: It is still not clear what part birth control pills might play in breast cancer risk. Studies have found that women now using birth control pills have a slightly greater risk of breast cancer. Women who stopped using the pill more than 10 years ago do not seem to have any increased risk. It's a good idea to discuss the risks and benefits of birth control pills with your doctor.

    Q: What about the relationship between breast-feeding and cancer incidence?

    A: Some studies have shown that breast-feeding slightly lowers breast cancer risk, especially if the breast-feeding lasts 1 to 2 years. This could be because breast-feeding lowers a woman's total number of menstrual periods, as does pregnancy. One study found that having more children and breast-feeding longer could reduce the risk of breast cancer by half.

    Q: What are some of the myths surrounding breast cancer causes?

    A: Internet e-mail rumors have suggested that underarm antiperspirants can cause breast cancer. There is very little evidence to support this idea. Also, there is no evidence to support the idea that underwire bras cause breast cancer.

    Q: Explain the roles pregnancy and menopause play in a woman's risk of breast cancer?

    A: Women who began having periods early (before 12 years of age) have a slightly increased risk of breast cancer.

    Women who went through the change of life (menopause) after the age of 55 have a slightly increased risk of breast cancer.

    Women who have not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer. Being pregnant more than once and at an early age reduces breast cancer risk.

    Q: Today, what are the survival rates for women with breast cancer?

    A: The overall five-year relative survival rate for women diagnosed with breast cancer is 88 percent. The 10-year relative survival rate is 80 percent.

    Q: How prevalent is breast cancer in the United States?

    A: In 2002 (the latest year figures are available), nearly 2.3 million women living in the United States had been diagnosed with breast cancer.

    Breast cancer is the most frequently diagnosed cancer in U.S. women (excluding cancers of the skin), with 211,240 cases of invasive breast cancer expected in 2005. This accounts for nearly one out of three cancers diagnosed in U.S. women.

    As far as cancer deaths are concerned, breast cancer ranks second in U.S. women (after lung cancer), with 40,410 deaths expected in 2005.


    CNN's Dr. Sanjay Gupta


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