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Breast cancer rate shows decade of decline

Judy Lane tried to convince the radiologist that her routine mammogram results didn't require a follow-up ultrasound.

"I had a cyst several years earlier," she says. "I told her it was just another cyst. I couldn't feel anything."

But further testing confirmed the concerns of the radiologist at the Hancock Regional Hospital in Greenfield, Indiana. Lane, a 61-year-old Fountaintown farm woman, had bilateral breast cancer.

Following surgery that summer, she adjusted her teaching schedule to undergo chemotherapy and radiation. Six years later, she takes a daily pill and has regular exams. She still works as a substitute teacher.

Lane is fortunate. Breast cancer is the second-leading cause of cancer-related death in the U.S. and the most common non-skin cancer. Mammography detects about 80% to 90% of breast cancers in women without symptoms.

The breast cancer diagnosis rate has risen, but overall death rate has dropped steadily since the early 1990s. New cases dropped 7% (about 14,000) between 2002 and 2003. One reason may be a significant decline in hormone replacement therapy (HRT). A 2002 Women's Health Initiative study linked a certain type of HRT to higher breast cancer risk.

But some advocates worry that the drop may be linked to fewer mammograms or less insurance coverage.

"We suggest annual mammograms and breast exams for women 40 and older with average risk," says Matt Flory, Minnesota Health Promotions, American Cancer Society, Mendota Heights. Women who are in their 20s to 30s are advised to have annual breast exams.

Ultrasound and digital mammograms are new tools to detect tumors in young women with dense breast tissue; magnetic resonance imaging targets cancer with genetic links.

Treatment today also is specialized. Researchers now know that breast cancer includes a half dozen or more different diseases linked to hormones, genetics, or other triggers. "The type of cancer determines the treatment options," Flory says.

Age is the most important risk factor. A close relative with breast cancer (on either parents' side) increases risk. Never having children or a first child after age 30 are risk factors.

"Some people think cancer is beyond their control," Flory says. "But they can improve their lifestyle and get regular screenings."

Reducing dietary fat is key; weight gain after age 18 is a risk. Women with low activity levels and a high body mass have twice the risk of women who exercise regularly.

"We battle the fear of cancer and complacency about regular screening," Flory says. "But the breast cancer survival rate is 70% to 90% if it's caught early. People never used to talk about cancer. Today people with breast cancer are not alone."

Lane agrees. "Every time I had chemo, people brought food for my family," she says. "I went online to read about treatment options. My sister had cancer in her 30s and again in her 60s. I saw her survive, and it helped me take it in stride."

American Cancer Society

Judy Lane tried to convince the radiologist that her routine mammogram results didn't require a follow-up ultrasound.

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