Breast cancer statistics

Information provided below is courtesy of the Susan G. Komen Foundation:

Breast cancer in women with disabilities

According to the Centers for Disease Control and Prevention, about 27 million women in the U.S. have a physical disability. A disability is a health condition that can make it hard to do daily tasks. Women who are disabled are just as likely to get breast cancer as other women, yet they tend to get screened for breast cancer less often than women without disabilities. Every woman needs to have regular screening tests.

A main barrier to breast cancer screening is lack of access. It may be hard for some disabled women to get to a clinic

or doctor’s office. And, some mobile mammography vans may not be designed well for women who have trouble getting around. The equipment used to screen for breast cancer may not adjust enough for some women to easily get into the right position or to sit.

Tips for women with disabilities

• Call places in your area to find one that meets your needs.

• Find a doctor who is sensitive to your needs. Ask your friends, family members and other disabled women for a referral.

• When you schedule your mammogram, let the staff know about your disability. It helps to talk about this up front since some places may not be right for you. For instance, if you find it hard to stand, ask if you can sit instead. Let the staff know if you need a sign language interpreter. If you can, tell them where to find one.

• Bring a friend or someone you trust. They may be able to help.

• If you are not happy with the services you receive, speak up. This may help increase access for you and others. Too often, clinics don’t know how to improve their services to meet their patients’ needs.

Increased risk for lesbian, gay and bisexual women

Lesbian, gay and bisexual women have a greater risk of breast cancer than other women. This is not because of their sexual orientation. Rather, it is linked to breast cancer risk factors that tend to be more common in these women. For example, these women may be more likely to never have children or have them later in life. Lesbians also tend to have higher rates of obesity and alcohol use. All of these factors increase breast cancer risk.

At this time, data on the risk of breast cancer among transgender people is limited. If you are transgender, talk with a doctor about your breast cancer risk and which screening tests may be right for you. It is important to find a doctor who is sensitive to your needs and to see that doctor on a regular basis.

Some findings show similar rates of screening mammography among lesbian, bisexual and heterosexual women. Yet other findings have shown lesbian and bisexual women may not get regular breast cancer screenings. This may be due to:

• Past experience of discrimination or insensitivity from doctors

• Perceived low risk of breast cancer

• Not having a regular doctor

• Lack of health insurance

Racial and ethnic breast cancer differences

Overall, new cases of breast cancer is about the same for black and white women. However, African-American women under age 45 have a higher incidence of breast cancer than white women.

Hispanic/Latina women are more likely than white women to be diagnosed with late stage breast cancers. They also tend to have larger tumors than white women. Breast cancer incidence is lower among Asian/Pacific Islander women than for white and black women.

New Asian-American immigrants also have lower rates of breast cancer than those who have lived in the U.S. for many years. Yet, for those born in the U.S., the risk is about the same as that of white women.

Black women tend to have poorer survival rates than women from other racial and ethnic groups in the U.S. Studies have found that they often have aggressive tumors with a poorer prognosis.

Breast cancer is still the most common cancer among Hispanic/Latina women. Their breast cancers are often found at a later stage. The chance of dying from breast cancer is higher if a tumor is found at a late stage.

Breast cancer treatment during pregnancy

Breast cancer during pregnancy is very rare. It occurs in about one out of every 3,000 pregnant women. Still, it is one of the most common cancers in pregnant women.

Most cancers in pregnant women are found during a clinical breast exam. Pregnant women get clinical breast exams as part of prenatal care. Screening mammography is not used in pregnant women because the radiation may harm the fetus and younger women usually do not get screening mammography.

When a lump is found during the first trimester, tests such as a breast ultrasound are used to check for breast cancer.

After the first trimester, a pregnant woman may have a diagnostic mammogram with a shield covering her abdomen to protect the fetus.

Breast cancer can be hard to detect in pregnant women because the increased size and change in texture of the breasts during pregnancy can make smaller cancers hard to feel. Therefore, breast cancers in pregnant women may be diagnosed at a more advanced stage than in non-pregnant women

There are special treatment concerns for pregnant women who have breast cancer.

Although cancer itself does not seem to affect the fetus, certain breast cancer treatments can be harmful. Your treatment plan and the timing of treatments are selected to treat your cancer as well as protect the fetus.

Surgery and radiation therapy

Breast cancer surgery is safe during pregnancy. Although the anesthesia used during surgery can cross the placenta to the fetus, it does not appear to cause birth defects or serious pregnancy complications.

Breast reconstruction, however, should be delayed until after the baby is born to avoid further anesthesia and the chance of blood loss.

A mastectomy is usually recommended for pregnant women who are in their first trimester and want to continue their pregnancy. Radiation therapy is needed after a lumpectomy and radiation can harm the fetus.

However, some women in their second or third trimester may consider lumpectomy. In these cases, radiation therapy is delayed until after the baby is born. This delay does not worsen prognosis.

Some women in their second or third trimester may have chemotherapy before surgery.

Chemotherapy is not given during the first trimester, as this is the time when the chances for drug-related birth defects and miscarriage are greatest.

During the second and third trimesters, some chemotherapy drugs can be used safely. However, chemotherapy should not be given after week 35 of pregnancy or within three weeks of the due date.This gives a woman time to recover from chemotherapy before delivery.

Many women diagnosed in their third trimester often wait and have chemotherapy after giving birth.

Hormone therapies and targeted therapies are not used at any point during pregnancy because of risks to the fetus.

Prognosis for women with breast cancer is similar to that of non-pregnant women, when age and cancer stage are taken into account. Ending a pregnancy does not improve prognosis.

Breastfeeding after a breast cancer diagnosis

If you have breast cancer while you are pregnant and wish to breastfeed, talk with your health care provider.

Breastfeeding should be avoided while being treated with radiation therapy, chemotherapy, hormone therapy or targeted therapy.

Some treatments may make it difficult to nurse from the treated breast.