River of Hope
There's reason to be hopeful about breast cancer: Rates are going down and more women are surviving the disease. Follow our guide to reduce your risk, get the best treatment, and help others cope.
Rachele Kanigel
10/2007
10/2007
It's hard to imagine a body part that stirs more
pleasure and more angst for women than breasts. As
10-year-olds, we wonder if they'll ever emerge. As young
women, we learn about their magnetic power to turn
men's heads. As nursing mothers, we revel in their ability
to give sustenance. And as sexual beings, we thrill when
they're stroked and caressed.
For all the joy they bring, they also trigger their share
of anxiety. We fret that they're too small or too big. We
worry about blue veins and sagging flesh. And worst of
all, we fear that an errant cell somewhere may be growing
and dividing, forming a tumor that could change our
lives forever.
The fear is real: About one in eight American women
will develop breast cancer during her lifetime. This year
an estimated 240,510 women will be diagnosed with
breast cancer and about 40,460 women will die of the
disease, according to the National Cancer Institute.
But even in the harsh statistics, there's some good
news: Breast cancer rates are on the decline and are
now at their lowest level since 1987. In 2003, researchers
noted a sharp drop in breast cancer incidence, followed
by another dip the following year, the last year for which
national statistics have been analyzed. Overall, in 2003
and 2004, 30,000 fewer women developed breast cancer
than health officials had predicted based on previous
trends, according to a study published this year in the
New England Journal of Medicine by biostatisticians at
the University of Texas M.D. Anderson Cancer Center.
The drop coincides with two other trends-a reduction
in the use of hormone replacement therapy and
declining use of screening mammography-so the question
remains whether there are fewer cases or if fewer
women with breast cancer are being diagnosed.
In 2002, millions of women dumped their hormone
supplements (and many others decided not to start taking
them) after the Women's Health Initiative reported
that women who were on hormone replacement therapy
for an extended period of time were at increased risk of
breast cancer, stroke, and heart attack. After analyzing
the data in detail, the M.D. Anderson researchers came to
the conclusion that the dramatic shift in hormone usage
could explain the drop in breast cancer cases.
However, some health officials believe the decrease
may also be related to a decline in the use of mammography.
The proportion of women 40 and older who said
they had a mammogram in the past two years dropped
from 70 percent in 2000 to 66 percent in 2005, according
to the National Cancer Institute. "There may be cancers,
but they'll be found later, when the disease is less treatable,"
says Christy Russell, M.D., codirector of the University
of Southern California/Norris Lee Breast Center.
