The Costs of Breast Cancer

Nearly 178,500 women in the United States were diagnosed with breast cancer in 2007 and about 40,000 died from the disease.¹ Breast cancer is a malignant tumor that starts in breast cells and can spread to other places in the body. Women in the United States have a 1 in 8 chance of getting invasive breast cancer, and 1 in 25 women will die from it.¹

Sex and age are the primary risk factors for breast cancer: 99% of breast cancers occur in women, and about 2 out of 3 people diagnosed with breast cancer are over 55.

Other risk factors include²:

• Genetic factors — 5% - 10% of breast cancers are believed to be linked to certain genes. Women with mutations in the BRCA1 and BRCA2 genes are 80% more likely to develop breast cancer.
• Family history of breast cancer.
• Past history of breast cancer.
• Race — White women are more likely to develop breast cancer than women of other racial backgrounds.
• Menstrual periods — Early menstruation (before age 12) and late menopause (after the age of 55).
• Radiation treatment of the breast or chest area earlier in life.

• Breastfeeding for 1.5 to 2 years.
• Limiting alcohol consumption: Women who consume more than 2 glasses of alcohol a day are 1.5 times as likely to develop breast cancer compared to women who drink less.
• Exercising regularly: An hour or more of exercise per week can reduce a woman's risk of breast cancer by 18%.

The best way to detect breast cancer early is to get a mammogram. A mammogram can identify cancer 1 to 4 years before a lump can be felt.¹ Screening is especially important because most women who get breast cancer have no identified risk factors for the disease. Because early detection leads to earlier treatment, screening can reduce mortality from breast cancer by 20% to 35% in women aged 50-69 and 20% in women aged 40-49.1 The U.S. Preventive Services Task Force recommends that women over the age of 40 receive a mammogram every 1 to 2 years. Women with identified risks for breast cancer may want to begin screening at an earlier age.

There are two types of mammograms, film and digital. Both use x-ray radiation to produce an image of the breast. A conventional mammogram is set on film. Digital mammogram pictures are saved on a computer in the patient's file and can be enhanced, manipulated, and sent electronically for further evaluation.⁴ While digital mammography offers several benefits, recent research has found that this technology is not cost-effective for all women.⁵ The research suggests that digital mammography is best reserved for younger women and women with dense breast tissue.⁵

The Costs of Breast Cancer:

• Breast cancer treatment costs nearly $7 billion a year in the United States.¹
• Almost $2 billion is spent on late-stage breast cancer treatment. When the cancer is found in the early stage, treatment is much less costly.¹

What Employers Can Do:

• Encourage women over 40 to get a mammogram every one to two years.
• Have employees support one another by being "buddies" to remind each other to get a mammogram.
• Provide free and easy-to-understand information to employees about breast cancer.
• Encourage employees to maintain a healthy lifestyle by eating fruits and vegetables, maintaining a healthy BMI, and exercising.
• Offer support for those who have had breast cancer and educate them on their continued risk for being diagnosed again.

References:

1. National Committee for Quality Assurance. Breast cancer screening. In: The State of Health Care Quality 2007. Washington: NCQA; 2007.
2. American Cancer Society. What causes breast cancer? Available at: http://www.cancer.org/docroot/CRI/CRI_2_1x.asp?dt=5. Accessed on February 7, 2008.
3. Centers for Disease Control and Prevention. Breast cancer: Reducing risk. Available at: http://www.cdc.gov/cancer/breast/basic_info/reducing_risk.htm. Accessed on February 6, 2008.
4. U.S. National Institutes for Health: National Cancer Institute. Screening Mammograms: Questions and Answers. Available at: http://www.cancer.gov/cancertopics/factsheet/Detection/screening-mammograms. Accessed on February 8, 2008.
5. Tosteson ANA, Stout NK, Fryback DG, et al. Cost-Effectiveness of Digital Mammography Breast Cancer Screening. Ann Intern Med. January 1, 2008;148(1):1-10.