For Immediate Release
September 21, 2010

KDHE Office of Communications
communications@kdheks.gov, 785-296-0461

Taking Charge of Your Breast Cancer Risk

An Op-Ed Column by Jason Eberhart-Phillips, MD
Kansas State Health Officer

A recent poll shows that breast cancer is the most feared disease among women. A little fear may be a good thing for raising public awareness, but fear also takes power away from people, power they need to prevent a serious disease like breast cancer.

Fortunately there’s a new willingness today to face up to our fears about breast cancer and help women around our state take charge of reducing their risk. The American Cancer Society’s “Making Strides” campaign is at the forefront of this awakening, as are the footraces and walking events sponsored by Susan G. Komen for the Cure.

The new attention to breast cancer prevention hasn’t come a moment too soon.

With nearly 2,000 invasive cases reported each year, cancer of the breast is the most frequently diagnosed cancer among women in our state. In fact, this one disease accounts for 30 percent of all cancers found in Kansas women today.

Despite exhaustive efforts to reduce the risk, there has been no real change in breast cancer rates in Kansas in the past 10 years. Year in and year out, approximately 380 women die from breast cancer here annually.

The highest risk is in women over 64 years of age, but cases among women in their 50s and early 60s are common, and 7 percent of cases occur in women under 40 years of age. There are no differences in incidence between whites and blacks, but the death rate among blacks is about 50 percent higher, due largely to later detection.

The combined cost for breast cancer to the Kansas economy is estimated at $38 million per year, including direct medical costs and lost productivity. The typical treatment cost paid by Medicaid for a confirmed case in Kansas is $20,000.

The odds of getting breast cancer vary according to a number of well-studied risk factors. Some of these factors cannot be changed, such as advancing age, having a family history of breast cancer, being a carrier of an altered form of the so-called breast cancer gene, or having a personal history of cancer in one breast already.

Other risk factors are potentially – but not easily – modifiable, such as getting your first menstrual period early (before age 12 years), having your first child after age 35 or never having a child, and reaching menopause after age 55 years.

Still other risk factors for breast cancer are more modifiable, at least with determined effort. These include being obese (especially in the waist), long-term use of hormone replacement therapy (combined estrogen and progestin), drinking more than two alcoholic drinks daily, having a diet that is high in fat and low in fruits and vegetables, and being physically inactive.

Many people overestimate family history in calculating their risk. In fact, genetic factors account for no more than 5 to 10 percent of cases. Most women who develop breast cancer have no close relatives with a history of the disease, and most female relatives of breast cancer patients will never get the disease themselves.

Far more important is what each woman does to understand her risk of breast cancer and the steps she takes to reduce it. That includes living a healthier lifestyle and making sure she is screened periodically with clinical breast examinations and mammograms.

Mammography detects 83 to 95 percent of cancers before they are clinically evident. The American Cancer Society recommends that women aged 40 and older obtain this test every year. The US Preventive Services Task Force does not recommend routine mammography until ages 50 to 74, and suggests that every two years is sufficient.

Surveys tell us that about 75 percent of Kansas women in the target age group have had at least one mammogram in the past two years, but that means that more than 165,000 Kansas women have not. Factors associated with not having a mammogram include a lack of insurance, low income, being unemployed, having less than a high school education, a history of smoking cigarettes and having never been married.

Breast cancer is much too common in Kansas today. It’s time to overcome our fears, let go of our sense of powerlessness, and fight back. Every woman can act to reduce her risk.

Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment. He can be reached at jeberhart-phillips@kdheks.gov. Go to his blog at: www.kdheks.gov/blogs/dr_jasons_blogs.htm.