Who is Most Affected by Breast Cancer?
Breast cancer is a serious disease, particularly when it is diagnosed in advanced stages. While there are many similarities among different populations with breast cancer, there are unique circumstances and characteristics in certain breast cancer populations, such as in African American women, young women, women who are pregnant, and men with breast cancer.
Advanced breast cancer in African American women
While Caucasian women have a slightly higher (approximately 3% more) breast cancer incidence rate as compared to African American women, the difference in incidence has been shrinking between the two, and breast cancer is the most common cancer in African American women. Generally, age is the biggest risk factor in breast cancer, with a woman’s risk of developing the disease increases as she ages. However, the rate of breast cancer in younger women (under age 45) is higher in African American women than Caucasian women.1
African American women also are more likely to die from breast cancer than Caucasian women. While the death rates from breast cancer have declined in each group, they have declined less in African American women. The difference in mortality rate is believed to be due to several factors, including a later stage at diagnosis, a higher rate of obesity and other health conditions, differences in access to high-quality cancer treatment, and differences in characteristics of breast cancer tumor(s).1
Advanced breast cancer in young women
Approximately 11% of all invasive breast cancers are diagnosed in women under the age of 45.2 Young women with breast cancer have additional challenges, including psychosocial challenges, fertility concerns, and the potential that treatment may induce premature menopause.3
When breast cancer occurs in a young woman, it is more common for there to be a family history of breast cancer and/or genetic mutations. Breast cancers in younger women tend to be more aggressive, and younger women are more likely to be diagnosed with larger tumors and have lymph node involvement. Breast cancer tumors in young women, especially in young African American women, are more likely to be “triple negative” – a type of breast cancer that is hormone receptor negative (estrogen receptor negative and progesterone receptor negative) and HER2 negative. One research study found that 56% of black women and 42% of white women with breast cancer aged 20-34 had triple-negative breast cancer.3
Advanced breast cancer in pregnant women
When breast cancer is diagnosed during a pregnancy, it can be complicated for both the mother and the baby. While breast cancer is rare during pregnancy, it occurs in an estimated 1 out of every 3,000 pregnancies.4
Breast cancer can be difficult to detect in pregnant or breastfeeding women, due to the breasts often becoming larger and/or lumpier, and potentially denser. These breast changes occur due to the hormone changes in pregnancy and can make it more challenging to find breast cancers when they are small, and many women who are diagnosed with breast cancer during pregnancy are in advanced stages of the disease.4,5
Treatment approaches for breast cancer in pregnant women must consider the health of both the mother and the baby. Some treatments may be dangerous for the unborn child and are not given during pregnancy, including hormone therapy and targeted therapy. Other treatments, including surgery, radiation, and chemotherapy, can potentially be given during pregnancy, although chemotherapy and radiation are not recommended during the first trimester (the first three months of pregnancy).4,6
Advanced breast cancer in men
While the majority of breast cancers occur in women, breast cancer can develop in men. In 2018, an estimated 2,550 men were predicted to be diagnosed with breast cancer. Men are more likely to be diagnosed at a later stage. This may be due in part to awareness of male breast cancer being lower, and men who do find a lump may delay in seeking diagnosis.7,8
While survival rates are similar for men and women with breast cancer diagnosed at the same stage, men have a higher mortality rate from breast cancer than women as it is often diagnosed at later stages of the disease.8,9