Where You Live Could Determine Your Breast Cancer Risk

Breast cancer is one of the most common cancers among women in the United States. Each year, roughly 240,000 cases are diagnosed, and an estimated 42,000 women die from the disease, according to the Centers for Disease Control and Prevention (CDC). While genetics and behavioral risk factors can increase a woman’s chance of developing breast cancer, a new study, recently published in JAMA Network Open, has found that where you live could also have a sizable impact. 

Areas with the highest rates of breast cancer

Using data from the Surveillance, Epidemiology, and End Results (SEER) database, researchers used a section of the data that provided adjusted mortality rates of breast cancer patients, spanning the years of 2015 to 2019 across 2,176 U.S counties.

The data provided a breakdown of the women’s demographics, their environment, pollution rates, lifestyle choices, and access to healthcare. 

“The goal of this study is to enable location-specific interventions that can be addressed at various levels of public health,” authors of the research said. 

What they found were ‘clusters and outliers of counties’ where breast cancer deaths occurred more frequently. A cluster with one of the highest rates was found to stretch from Kansas through Oklahoma east to Arkansas, Louisiana, Mississippi, Alabama, and Georgia and then up through South and North Carolina to Virginia. Another high cluster was observed along the borders of Kentucky, West Virginia, and Ohio. 

In contrast, clusters of counties with some of the lowest rates were observed in California, Arizona, much of the Northeast, and parts of the Midwest. 

Researchers also compared mortality rates relative to their neighbors and found outliers like Buffalo County, New York which had a much higher breast cancer mortality rate than its surrounding counties, while Madison County, Tennessee, had a much lower breast cancer mortality rate than its surrounding counties.

And northern Alabama had much higher rates of breast cancer deaths, compared to the southern part of the state, which researchers noted was an example of how the same statewide health program could have different outcomes in various parts of the state. 

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What the research showed

While mortality rates from breast cancer were significantly higher in certain parts of the country, the study also showed that obesity rates were often higher in these areas as well. Other factors or lifestyle choices like smoking, access to healthy food and its affordability, exercise rates, and racial segregation were associated with more breast cancer deaths. 

Limited access to healthy food was notably prominent in places that had larger populations of non-Hispanic Black female populations, and was associated with more breast cancer deaths in southern and eastern U.S. counties.

Limited access to mental and primary healthcare were also contributors to larger rates of breast cancer deaths, while areas with greater access to mammograms and education on mammograms showed much smaller rates. The study also showed that obesity rates significantly affected breast cancer mortality across all locations, with no outliers. 

Breast cancer deaths were also not higher in the uninsured population of women in any county researchers looked at, but they were associated with a greater proportion of uninsured women overall.

When to begin mammogram screenings and other resources

Early detection is key to preventing breast cancer deaths, and according to the CDC, compared to no screening, screening every two years for women aged 50 to 74 can reduce breast cancer deaths by 26 percent.

The U.S. Preventive Services Task Force, a panel of experts that issues guidelines about preventive care, recommends that healthy women who have not had breast cancer and are between the ages 40 and 74 get a mammogram every other year, although other medical organizations or your doctor might endorse annual mammograms. 

If you are someone who has had breast cancer, notices an unusual lump, has received high-dose radiation to the chest, or has had breast lesions identified in previous biopsies, you should consult with your provider about the frequency of mammogram screenings. 

And if you’re overdue for an at-home breast exam to check for any usual lumps or changes to texture, the National Breast Cancer Research Foundation recommends the following. 

  1. When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and put your right arm behind your head. 
  2. Using your left hand, move the pads of your three middle fingers around your right breast, covering the entire breast area and armpit.
  3. Use light, medium,and firm pressure to feel for any new lumps, thickenings, hardened knots, or any other breast changes. Also squeeze the nipple to check for discharge. Repeat these steps for your left breast.

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