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Breast cancer

ICD-10 C50
2017

¹ per 100,000 persons, age-standardised according to the old European standard population

* calculated using the period method for 2015 / 2016

WomenMen
Incidence67,297647
Age-standardised incidence rate¹108.31.0
Deaths18,396192
Age-standardised mortality rate¹22.80.3
5-year prevalence300,7002,700
10-year prevalence555,7004,300
Relative 5-year survival rate*87 %77 %
Relative 10-year survival rate*82 %72 %

With approximately 67,000 annual incident cases, breast cancer is by far the most common cancer in women. In addition, more than 6,000 women are diagnosed with an in situ breast tumour every year. About 1 percent of all new cases of breast cancer affect men.

Based on current incidence rates, about one in eight women is expected develop breast cancer over the course of a lifetime. Almost three out of ten affected women are below 55 years of age at diagnosis. Rates of new cases and deaths remain lower in former East German states than in former West German ones; only for women below 55 years of age have the rates largely converged.

What is the effect of mammography screening?

Following the introduction of the mammography screening programme in Germany for women between the ages of 50 and 69 years (between 2005 and 2009, depending on the region), diagnosis rates in the corresponding age group initially rose sharply. Since 2009, however, they have been declining continuously and in 2016 were only slightly higher than before the screening programme. A recent publication shows that, in the screening age group, about 25 percent fewer women are diagnosed with advanced tumours than before the introduction of screening. Mammography screening also appears to have had an impact on breast cancer mortality: since around 2008 the mortality rate has developed much more favourably in the screening age group than in women under 50 or over 70.

Estimated age-standardised incidence rates of breast cancer in women eligible for mammography screening (50-69 years old) and other age groups (30-49 years old, 70 years and older), Germany 1999-2016, per 100,000 (old European standard) © ZfKD at the RKI Estimated age-standardised incidence rates of breast cancer in women eligible for mammography screening (50 - 69 years old) and other age groups (30 - 49 years old, 70 years and older), Germany 1999 - 2016, per 100,000 (old European standard population)

Progress in therapy has substantially improved the survival chances of people diagnosed with breast cancer, and this has led to a decrease in mortality rates as well. Within a few years’ time, it should be possible to assess the extent to which screening has brought about a further reduction.

Hormones influence the risk of breast cancer

Hormones can influence the risk of disease: Early first and late last menstruation, childlessness or a higher age at first birth are considered risk factors. Hormone replacement therapy can increase the risk of breast cancer, especially prolonged, combined oestrogen-progestin therapy. Ovulation inhibitors containing hormones (birth control pills) increase breast cancer risk slightly.

Very dense breast tissue, certain benign breast changes or a previous history of breast cancer are also among known breast cancer risk factors.

Some breast cancers are due to an increased genetic risk: Women whose close relatives have been diagnosed with breast or ovarian cancer have an elevated risk of developing breast cancer themselves. Similarly, the risk of breast cancer increases after radiotherapy of the breast during childhood or adolescence.

Lifestyle factors such as overweight and lack of exercise after menopause as well as alcohol consumption are also risk factors. Smoking could also slightly increase risk.

What screening tests are available?

The early detection programme of the statutory health insurance offers women 30 years of age and over an annual palpation examination by a physician. Women between the ages of 50 and 69 years are invited to an X-ray examination of the breast every two years as part of the mammography screening programme.

Date: 21.04.2021

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