Definition

Incidence rate of invasive breast cancer in females for a defined population in a specified time interval. Rates are age-adjusted to the 2000 U.S. Standard Population. Rates are per 100,000 population.

Numerator

Number of new cases of breast cancer in females among a defined population in a specified time interval.

Denominator

Defined population in a specified time interval.

Why Is This Important?

In New Jersey, 7,855 women were diagnosed with breast cancer in 2018. Breast cancer is the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in American women, after lung cancer.

How Are We Doing?

Between 1990 and 2018, the average age-adjusted breast cancer rate in females was 135.7 per 100,000. During the same time period, the age-adjusted breast cancer rate for women age 50 and older decreased from 397.5 cases to 361.1 cases per 100,000. The lifetime risk of developing breast cancer is 1 in 8 for women and 1 in 769 for men.

What Is Being Done?

A Comprehensive Cancer Control Plan was developed by the Task Force on Cancer Prevention, Early Detection and Treatment in New Jersey which aims to reduce the incidence, illness and death due to cancer among New Jersey residents. [https://www.cdc.gov/cancer/ncccp/ccc_plans.htm]

Available Services

The New Jersey Department of Health (NJDOH) has many programs and partnerships related to cancer data and information, cancer resources and cancer prevention. Cancer Epidemiology Services: [https://nj.gov/health/ces/] Interactive New Jersey cancer incidence and mortality data, as well as numerous publications, are available through the NJDOH website for cancer statistics and mapping. [https://www.nj.gov/health/ces/cancer-researchers/cancer-data/index.shtml] Office of Cancer Control and Prevention: [https://www.nj.gov/health/ces/public/resources/occp.shtml] NJ Cancer Education and Early Detection (NJCEED): [https://www.nj.gov/health/ces/public/resources/njceed.shtml] NJ Commission on Cancer Research: [https://www.nj.gov/health/ces/cancer-researchers/njccr.shtml]

Health Care System Factors

According to the [https://www.cancer.gov/types/breast/hp/breast-prevention-pdq National Cancer Institute], use of combination '''hormone therapy''' (estrogen-progestin) is associated with approximately a 25% increase in the risk of invasive breast cancer. Also, exposure of the breast to '''ionizing radiation''' (for example, during radiation therapy for Hodgkins lymphoma) is associated with an approximately sixfold increase in the risk of developing breast cancer overall. (Risk is especially high if exposure occurs during puberty, when the breast develops.) [Last reviewed: 1/26/20] Since November 2018, the [https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions United States Preventive Services Task Force] has recommended '''screening for unhealthy alcohol use''' in primary care settings in adults 18 years or older and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use. [Last reviewed: 1/21/20]

Risk Factors

According to the [https://www.cancer.gov/types/breast/hp/breast-prevention-pdq National Cancer Institute], the major risk factors for breast cancer are '''female sex''' and '''increasing age'''. Women with '''dense breasts''' have an increased risk proportionate to the degree of density. Among women with a '''family history of breast cancer''', risk is doubled if a single first-degree relative is affected and risk is increased fivefold if two first-degree relatives are diagnosed. Also, the lifetime risk is 55% to 65% for '''BRCA1''' mutation carriers and 45% to 47% for '''BRCA2''' mutation carriers compared to a lifetime risk of 12% in the general population. Reproductive risk factors: Women who have a '''full-term pregnancy''' before age 20 years have a 50% decrease in breast cancer risk compared with nulliparous women or women who give birth after age 35 years, and women who practice '''breast-feeding''' have a 4% decrease in risk of breast cancer for every 12 months of breast-feeding in addition to 7% for each birth. Also, undergoing oophorectomy or other forms of '''premature menopause''' may reduce breast cancer risk as much as 75% depending on age, weight, and parity, with the greatest reduction for young, thin, nulliparous women. Conversely, women who experience '''menarche at age 11 years or younger''' have about a 20% greater chance of developing breast cancer than do those who experience menarche at age 14 years or older. Behavioral risk factors: [https://www-doh.state.nj.us/doh-shad/query/builder/njbrfs/AlcoholChrnHvy/AlcoholChrnHvyCrude11_.html Alcohol consumption] is associated with increased breast cancer risk in a dose-dependent fashion and '''obesity''' is associated with an increased breast cancer risk in postmenopausal women who have not used combination hormone therapy (although it is uncertain whether either reduced alcohol consumption among women who are heavy drinkers or weight reduction among obese women decreases the risk of breast cancer). Conversely, '''exercising strenuously''' for more than 4 hours per week is associated with an average RR reduction of 30% to 40%. (The effect may be greatest for premenopausal women of normal or low body weight.) [Last reviewed: 1/26/20]

Health Status Outcomes

Using data from SEER 18 (2009-2015), the [https://seer.cancer.gov/statfacts/html/breast.html National Cancer Institute] found the five-year '''relative survival''' for women diagnosed with breast cancer to be approximately 90% overall. [Last reviewed: 1/27/20]

Data Notes

Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ..., 80-84, 85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified.

Data Notes

Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ..., 80-84, 85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified. Number of cases (numerator) is the total count of cases in five years.

Data Notes

Incidence rates (cases per 100,000 population per year) are age-adjusted to the 2000 US standard population (19 age groups: <1, 1-4, 5-9, ..., 80-84, 85+). Rates are for invasive cancer only (except for bladder cancer which is invasive and in situ) or unless otherwise specified.

References and Community Resources

NIEHS fact sheet, Breast Cancer Risk and Environmental Factors [https://www.niehs.nih.gov/health/assets/docs_a_e/environmental_factors_and_breast_cancer_risk_508.pdf]. More information on breast cancer is available from the NJ State Cancer Registry, [https://nj.gov/health/ces/documents/briefs/fem_breast_inc_mort_race_eth.pdf].