Breast Cancer Toolkit

Breast cancer is an uncontrolled growth of breast cells. Breast cancer is the second leading cause of cancer death and, excluding skin cancers, the most frequently diagnosed cancer among U.S. females – affecting one in eight women. An estimated 4,400 Hoosiers were diagnosed, and 889 lives were lost as a result of breast cancer, during 2011. African American females are at increased risk for poor outcomes relating to breast cancer, in part, because they are more often diagnosed at a younger age, at a later stage of disease, and with more aggressive forms of breast cancer. Beginning at the age of 50, screening mammograms are recommended yearly for females and are shown to significantly increase survival rates. Breast cancer is rare among males; however, because males are prone to ignoring warning signs, they are often diagnosed at later stages and have poorer prognoses. 

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Who gets Breast Cancer Most Often?

Sex and age are the two greatest risk factors for developing breast cancer. Females have a much greater risk of developing breast cancer than do males, and that risk increases with age. Overall, in Indiana, the breast cancer incidence and mortality rates have decreased from 2002 to 2011.

Some additional risk factors include:

  • Genetics. Females who have two or more first degree relatives who have been diagnosed with breast cancer before the onset of menopause have increased risk. Additionally, breast cancer risk increases if a female has a family member who carries the BRCA 1 or 2 genes, which account for five to ten percent of breast cancer cases.
  • Race. In Indiana, during 2007-2011, the breast cancer incidence rates for African American and white women were similar, but the mortality rate for African American women was 39 percent higher than for whites. This increased risk can partially be attributed to African American women being diagnosed with more aggressive forms of breast cancer or at later stages.
  • Estrogen. Females who started menstruation before age 12 or menopause after age 55 might be at increased risk as a result of a higher lifetime exposure to estrogen.
  • Pregnancy and breast feeding history. There are studies that show that females who have not had children, had their first child after age 30, or have not breastfed might have an increased risk of developing breast cancer.
  • History of hormone replacement therapy (HRT). Using HRT can increase a females’ risk of developing and dying from breast cancer. This risk can be increased after just two years of using HRT. Females should talk with their doctor about the risks and benefits of using HRT.
  • Certain medical findings. High breast tissue density, high bone mineral density, and biopsy-confirmed hyperplasia (an overgrowth of the cells that line the ducts or the lobules) increase females’ risk for developing breast cancer.
  • Alcohol intake. Having two or more alcoholic drinks a day increase female breast cancer risk by 21 percent.
  • Weight and exercise. Gaining weight after age 18 and being overweight, especially post menopause can increase your risk of developing breast cancer. The more body fat a woman has the higher her estrogen levels typically are, increasing her risk of developing breast cancer. According to the 2008 Physical Activity Guidelines for Americans (, adults should perform 150 minutes of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on two or more days a week that work all major muscle groups (i.e., legs, hips, back, abdomen, chest, shoulders, and arms).  

Common Signs and Symptoms of Breast Cancer

Some common signs and symptoms of breast cancer include:

  • Lumps, hard knots, or thickening
  • Swelling, warmth, redness, or darkening
  • Pulling in of the nipple or other parts of the breast
  • Change in size or shape
  • Nipple discharge that starts suddenly
  • Dimpling or puckering of the skin
  • Itchy, scaly sore, or rash on the nipple
  • New pain in one spot that doesn’t go away

Early Detection

Early detection is critical for breast cancer. Females should have frequent conversations with their health care provider about their risks for breast cancer and how often they should be screened. In general, females should follow these recommendations:

  • Breast Self Awareness. Women in their 20s should be aware of the normal look and feel of their breasts, so that they can identify potentially dangerous changes.
  • Clinical Breast Exams. Women in their 20s and 30s should have a clinical breast exam by a health care professional every three years. Women in their 40s should have yearly clinical breast exams.
  • Annual Screening Mammograms. Women, beginning at the age of 50, should have yearly screening mammograms, which help detect cancers before a lump can be felt.  Women with increased risk for breast cancer should begin talking to their doctor about the risks and benefits of mammography beginning at age 40.

The five-year survival rate for localized breast cancer (cancer that has not spread to lymph nodes or other locations outside the breast) is 98 percent. It is important to educate both men and women about the importance of early detection, and encourage them to have critical conversations about appropriate screenings with their healthcare provider.



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