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BREAST CANCER EPIDEMIOLOGY AND BREAST PHYSIOLOGY

BREAST CANCER EPIDEMIOLOGY AND BREAST PHYSIOLOGY. Benjamin O. Anderson, M.D. Director, Breast Health Clinic Professor of Surgery and Global Health, University of Washington Joint Member, Fred Hutchinson Cancer Research Center Seattle, Washington. MYTH #1.

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BREAST CANCER EPIDEMIOLOGY AND BREAST PHYSIOLOGY

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  1. BREAST CANCER EPIDEMIOLOGY AND BREAST PHYSIOLOGY Benjamin O. Anderson, M.D. Director, Breast Health Clinic Professor of Surgery and Global Health, University of Washington Joint Member, Fred Hutchinson Cancer Research Center Seattle, Washington

  2. MYTH #1 “Cancer is an insignificant health care issue in low and middle income countries (LMCs).” FACT:Cancer is the second most common cause of death in LMCs, more than respiratory infections and diseases, HIV/AIDS, diarrheal diseases and tuberculosis

  3. CAUSES OF DEATH:Low-Income and Lower-Middle Income Countries • Cancer 4.4 million • Respiratory infections 3.5 million • Respiratory diseases 3.0 million • HIV/AIDS 2.7 million • Diarrheal diseases 1.8 million • Tuberculosis 1.5 million NEJM 356:3, 2007 (from WHO 2005)

  4. MYTH #2 “Breast cancer REALLY only affects countries of wealth.” FACT:Breast cancer is the most common cancer among women around the globe, and the most likely reason that a woman will die of cancer.

  5. BREAST CANCER EPIDEMIOLOGY: Incidence and Mortality in U.S. • Breast cancer incidence rates • Most common cancer among women (31%) • Breast cancer mortality rates • Second most common cause of cancer deaths among women (15%) • Lung cancer became leading cancer killer in mid 1980’s CA-A Journal for Clinicians 52:23, 2002

  6. CANCER INCIDENCE RATES FOR U.S. WOMEN, 1973-2005 Age-adjusted Incidence Rate per 100,000 Females

  7. CANCER DEATH RATES FOR U.S. WOMEN, 1930-2005 Age-adjusted Death Rate per 100,000 Females

  8. BREAST CANCER: Incidence and Mortality in World • Third most frequent cancer in world (male + female) • 1990: 796,000 cases, 314,000 deaths • 2002: 1,152,000 cases, 411,000 deaths • Most common cancer among women worldwide • Most common cause female cancer deaths • Most breast cancer deaths occur in less developed countries CA Cancer J Clin: 49:33, 1999 Globocan 2002 (IARC)

  9. WORLD BREAST CANCER STATISTICS:Incidence and 5-Year Survival CA Cancer J Clin: 50:37, 2000

  10. GHANAIAN CANCER EPIDEMIOLOGY:Age Standardized Rates (ASR) / 100,000 Females Globocan 2002

  11. BREAST CANCER EPIDEMIOLOGY:Stage atdiagnosis: United States vs. India USA: 90% DCIS or early staged invasive disease at diagnosis INDIA: 76% locally advanced or metastatic at diagnosis Sources: SEER Survival Monograph (NCI), 2007; Chopra, Cancer Institute Chennai, India, 2001

  12. THE HEALTHY BREAST:In Utero Mammary Development

  13. THE HEALTHY BREAST:Breast Maturation during Pregnancy

  14. PROGRESSION OF DISEASE METASTASIS

  15. SEATTLE CANCER CARE ALLIANCE UNIVERSITY OF WASHINGTON FRED HUTCHINSON CANCER CENTER CHILDREN’S HOSPITAL UNIVERSITY OF WASHINGTON FRED HUTCHINSON CANCER CENTER

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