Breast Cancer in Canadian Women

Abstract

Health issue: Although lung cancer is the leading cause of cancer deaths for Canadian women, breast cancer is the most frequently diagnosed. About 5400 women are expected to die from this disease in 2003. In 1998, a woman's lifetime risk of breast cancer was about one in nine.Key findings: A number of risk factors for breast cancer have been identified. These include advancing age, hormonal factors (eg. early menarche, late menopause and late age at first full-term pregnancy), familial risk, BRCA-1 and BRCA-2 gene mutations, diet and postmenopausal obesity.Several interventions have been introduced to assist women at high risk for breast cancer, including genetic counseling and testing for women who have strong family histories of breast cancer; selective estrogen receptor modifiers, such as tamoxifen, that has been shown to reduce breast cancer rates; prophylactic mastectomy and screening. Data gaps and recommendations:Guidelines are unclear in several areas, particularly in screening. Where clinical guidelines are available, health services research or ongoing monitoring (by provincial/territorial cancer agencies) is needed to assess compliance with the guidelines and to ensure equity of access within the provinces/territories. Key components of organized screening programs need to be established, in part to ensure that screening is carried out in high-quality, co-ordinated programs. There is also a need to develop ways to involve women fully in informed decision-making and to address several policy issues to prevent disparities in access to high-quality services. Patenting issues associated with genetic tests also need to be clarified.

Early Detection and Prevention of Breast Cancer: The Increasing Importance of Midwives in the Future

“…However, the changes in number of live births, number of live births per 1,000 population, total fertility rate, age of mother at first birth and age of mother at birth in total, and mean age of death in women in the period from 1961 to 2006, certainly suggest that there are now many more women exposed to the risk of BC than four or five decades ago (Armstrong & Nguyen, 1999;Bryant, 2004;Curado et al (Eds. ), 2009;Henderson et al, 1996;International Agency for Research in Cancer, 2008;Soerjomataram et al 2008).…”

“…On the whole, increased risk of BC is associated with female gender, advancing age and age during menstrual life, hormonal factors (early menarche and late menopause), nulliparity and age of over 30 years at first birth, obesity and estrogen therapy after the menopause, harmful drinking of alcohol and history of benign proliferative lesions in the breast (Armstrong & Nguyen, 1999;Bryant, 2004;Cancer Registry of Republic of Slovenia, 2010;Curado et al (Eds. ), 2009;Henderson et al, 1996;International Agency for Research in Cancer, 2008;Soerjomataram et al, 2008).…”