What is breast cancer?
Breast cancer is the most common cancer among women in England, accounting for 31% of all newly diagnosed cases of cancer in females in 2011. Breast cancer broadly falls into two groups: non-invasive breast cancer, which is found in the ducts of the breast and has not developed the ability to spread outside the breast, and invasive breast cancer, which can spread outside the breast (NHS Choices, 2012). Here we focus on invasive breast cancer, which accounted for almost 90% of new breast cancer registrations in 2011 (Office for National Statistics, 2013).
In 2011, there were around 41,500 newly diagnosed cases of breast cancer in females. The incidence rate has increased from 66 new cases per 100,000 women in 1971, to 125 new cases per 100,000 women in 2011. This amounts to an increase of 89% over this time period. As with many cancers, much of the rise in incidence is due to people living longer.
Figure 1: Breast cancer incidence and mortality rates, females, England, 1971–2011
Breast cancer risk factors
Age is the biggest risk factor for breast cancer, after gender, with a peak in registrations among those aged 60–64, representing 13% of all new breast cancer cases in 2011, (Office for National Statistics, 2013). In 2011, around 80% of all newly diagnosed cases of breast cancer were in women aged 50 and above. It is estimated that about 27% of cases of female breast cancer in the UK are linked to lifestyle and environmental factors, such as obesity, smoking, alcohol consumption, and lack of physical activity (Parkin, Boyd and Walker, 2011). Family history has also been shown to be associated with an increased risk of developing breast cancer (Metcalfe, Finch, Poll, et al, 2009).
Figure 2: Registrations of newly diagnosed cases of breast cancer by age group, females, England, 2011
Incidence rates have risen, mortality rates have fallen
In 2011, around 9,700 women died of breast cancer in England. Although incidence rates have steadily increased over the last 40 years, there has been a marked decrease in mortality rates. The mortality rate has decreased from 39 deaths per 100,000 women in 1971, to 24 deaths per 100,000 women in 2011. This represents a 38% decrease in mortality over this time period.
Survival estimates have improved significantly
Survival estimates for those diagnosed with breast cancer have increased by more than 50% since 1971. For women (aged 15–99 years) diagnosed with breast cancer between 2006 and 2010 and followed up to 2011, the five-year survival estimate was around 84% (Office For National Statistics, 2012). In comparison, among women diagnosed between 1971 and 1975 and followed up to 1995, only around 54% survived for five years or more (Coleman, et al. 1999). The improvement in breast cancer survival is associated with earlier detection and advances in treatment. Breast cancer survival was third highest after melanoma of the skin and Hodgkin lymphoma, for women diagnosed with cancer between 2006 and 2010 and followed up to 2011.
For most cancers, survival rates are generally higher among younger patients. For breast cancer, the reverse is true: Survival is lower for women aged 15–39 (84%) than those aged 40–69 (89–90%) (Office for National Statistics, 2012).
Breast cancer screening in England
The NHS Breast Screening Programme was introduced in 1988. The aim of screening is to detect breast cancer at an early stage when there is a better chance of successful treatment. In 2011–2012, 1.94 million women aged 45 and over were screened within the programme. Of these, 15,749 had breast cancer detected, a rate of 8 cancers per 1,000 women screened (Health and Social Care Information Centre, 2013).
Coleman MP, Babb P, Damiecki P, Grosclaude P, Honjo S, Jones J, et al. (1999). Cancer survival trends in England and Wales, 1971-1995: deprivation and NHS region. London: Stationery Office.
Health and Social Care information Centre (HSCIC) (2013). NHS Breast Screening Programme Statistical Bulletin (England) 2011 - 2012.
Metcalfe KA, Finch A, Poll A, et al, (2009). Breast Cancer risks in women with family history of breast cancer who have tested negative for a BRCA1 or BRCA2 mutation.
NHS Choices (2012). Breast Cancer in females.
Office for National Statistics, (2012). Cancer survival in England: patients diagnosed 2006-2010 and followed up to 2011.
Office for National Statistics, (2013). Cancer Registration Statistics, England, 2011.
Parkin DM, Boyd L, Walker LC, (2011). The Fraction of Cancer attributable to lifestyle and environmental factors in the UK.
Rates are calculated using mid-year population estimates. Mortality and cancer incidence rates for 2002 to 2011 presented in this short story have been revised using population estimates based on the 2011 census, and will differ from rates previously published. Cancer incidence rates are also updated annually to take account of late registrations received after the cut-off date for each registration year.
These statistics were compiled and analysed by the Cancer and End of Life Care Analysis team in the Life Events and Population Sources Division. If you’d like to find out more about our cancer statistics you can read our annual reference volume and see further stories, for example on Leukaemia. If you have any comments or suggestions, we’d like to hear them! Please email us at: firstname.lastname@example.org.