A new report from the American Cancer Society finds that death rates from breast cancer in the U.S. have dropped 39% between 1989 and 2015. This translates to 322,600 deaths avoided during those 26 years. African-American women still have higher breast cancer death rates than white women nationally.
The steep declines in breast cancer death rates since 1989 are attributed to improvements in treatment and early detection by mammography. Unfortunately, not all women have benefited equally from these improvements. A striking divergence in long-term breast cancer mortality trends between black and white women emerged in the early 1980s and continued to widen over the last several decades, but recent data suggest that the racial disparity may be stabilizing.
The findings come from Breast Cancer Statistics, published in "CA: A Cancer Journal for Clinicians" and its companion consumer publication Breast Cancer Facts & Figures 2017-2018, reports published every two years by ACS to describe the latest trends in breast cancer incidence, mortality, survival, and screening by race/ethnicity, as well as current information on risk factors, prevention, early detection, treatment, and research.
Breast cancer is the most common cancer among women in the U.S., after skin cancer. By the end of 2017, an estimated 252,710 women will be diagnosed with breast cancer. It is the second leading cause of cancer death among women in the U.S., after lung cancer; 40,610 women in the U.S. are expected to die from this disease in 2017.
Breast cancer risk generally increases with age. About 8 of every 10 new breast cancer cases and almost 9 of every 10 breast cancer deaths are in women 50 years old and older.
Number of breast cancer survivors in U.S.
On January 1, 2016, more than 3.5 million women were living in the U.S. with a history of breast cancer. Some of them were cancer-free, while others still had evidence of cancer and may have been undergoing treatment.
Race and ethnic factors
White women and black women have higher breast cancer incidence and death rates than women of other racial and ethnic groups. Asian and Pacific Islander women have the lowest incidence and death rates.
Racial differences nationwide
White women get breast cancer at a slightly higher rate than black women. During 2010 through 2014, the overall incidence rate was 2% higher in white women. But black women are more likely to get breast cancer before they are 40, and are more likely to die from it at any age. They also have higher rates of triple negative breast cancer, which as an aggressive kind of breast cancer with lower survival rates. The breast cancer death rate during 2011 through 2015 was 42% higher in black women than in white women.
Racial differences by state
Breast cancer death rates are higher in black women than white women in every state. The excess death rate among black women ranges from 20% in Nevada to 66% in Louisiana. However, seven states did not have statistically significant differences in death rates. In 4 of those states (Iowa, Minnesota, Nebraska, and Rhode Island), the similar death rates may be because the numbers of deaths among black women were very small, making it harder to compare. In three states (Massachusetts, Connecticut, and Delaware), the authors say the closing gap may represent improvements in access to health care.
According to Carol DeSantis, MPH, our director, Breast and Gynecological Cancer Surveillance, "A large body of research suggests that the black-white breast cancer disparity results from a complex interaction of biologic and nonbiologic factors, including differences in stage at diagnosis, tumor characteristics, obesity, other health issues, as well as tumor characteristics, particularly a higher rate of triple negative cancer.
"But the substantial geographic variation in breast cancer death rates confirms the role of social and structural factors, and the closing disparity in several states indicates that increasing access to health care to low-income populations can further progress the elimination of breast cancer disparities."
Prevention and early detection
The overall declines in breast cancer death rates since 1989 have been attributed to both improvements in treatment and early detection by mammograms. Following American Cancer Society guidelines for breast cancer screening can help women find breast cancer earlier when treatments are more likely to be effective.
Women can help lower their risk of breast cancer by making healthy lifestyle changes.
- Get to and stay at a healthy weight. Studies show obesity and excess weight increase the risk of developing breast cancer. Losing even a small amount of weight has health benefits and is a good place to start.
- Be physically active. Growing evidence suggests that women who get regular physical activity have a lower risk of breast cancer compared to women who get no exercise. Doing even a little physical activity beyond your regular daily routine can have many health benefits.
- Limit alcohol. Many studies have confirmed that drinking alcohol increases the risk of breast cancer in women. If you do drink alcohol, the American Cancer Society recommends women limit themselves to no more than 1 drink per day.