Breast cancer is the most common cancer in women in most parts of the world. There is a marked geographical variation in incidence rate. The incidence is highest in North Europe and North America, intermediate in the Mediterranean countries and South America and lowest in Asia and Africa. The mean age at diagnosis reported in most developing countries is around 50 years compared to 60 years in Western countries.

In 2000, there were 1,050,346 cases reported with 372,969 deaths from breast cancer world-wide. The incidence ranged from an average of 95 per 100,000 in more developed countries to 20 per 100,000 in less developed countries.

These variations have been attributed to variations in body size, diet, reproductive characteristics such as age of menarche (first period in females), parity (number of children), age at first childbirth, and age at menopause. The incidence rates also vary with race, being higher in white women compared to black, Hispanic or Asian-American in the United States of America (USA).

The incidence (number of new cancers) is steadily increasing. The statistics are more frightening in countries like the USA where about 184,000 new cases of breast cancer are detected annually. The National Cancer Institute estimates that by age 50, one out of every 50 women will develop breast cancer. By age 80, it will rise to one in 10. If this risk is calculated over their lifetime, one in 8 women will suffer from breast cancer. One in 28 will die of the disease. One in 3000 women develop breast cancer during pregnancy and pregnant women tend to develop them usually in their 30s. (Only 2% of breast cancers are diagnosed in pregnant women.)

Presented in another way:

In countries where rates have been low, especially in Asia, the rate of increase has been the greatest with steep increases in the incidence as well as death rate (mortality)

Breast Cancer in Malaysia - the stark facts

In comparison, the next (2nd) commonest cancer in Malaysian women in 2002 & 2003 was cancer of the cervix, which only formed 12% and 12.9% respectively of total female cancers.

The statistics for Malaysia was sourced from the National Cancer Registry Reports 2002 and 2003. Over time, the pattern of cancers, including breast cancer will be better established. It is only with continued reliable data that important decisions on planning and policy management can be made for Malaysia.

Estimates by the International Agency for Research in Cancers (Globocan 2000) reported that in 2000, there were 3825 cases reported and 1707 deaths from breast cancer in Malaysia. Globocan 2000 estimated the crude rate of breast cancer in Malaysia of 34.9 per 100,000 population with Age Standardised rate of 41.9 per 100,000.

Breast Cancer in Singapore

The Singapore Cancer Registry also reported a lower incidence in Malay women compared to Chinese and Indian women. Singapore has recorded a rising trend of 3.7% per annum in the incidence rate of breast cancer from 1968 to 1997. The age-specific incidence shows a peak in the 40-49 year age group and then, a decline. This is unlike the age-specific incidence curve of American women that rises rapidly until the age of 50 years and then, there is a slower rate of increase but the curve continues to rise.

Breast Cancer in University Malaya Medical Centre, Kuala Lumpur (1993-2003)

Over the years from 1993 to 2003, there were a total of 1818 breast cancer patients in the University Hospital. The number of breast cancer patients increased annually, with the highest recorded in 2003. This was 6 times the number of breast cancer patients in 1993.

Breast cancer is more common in Chinese women compared to Malay women. 2% of these patients were below 30 years of age. The majority of the cancer patients were in the 40-49 year age group when they were first diagnosed. However, this is NOT age-specific incidence but hospital incidence that could be influenced by the population it serves. Perhaps, there is a younger urban population or perhaps, the older folks prefer traditional/kampung treatment. 30-40% of the patients presented in the late stage and although women are now presenting with smaller tumours, the decrease in size is not significant.

This has been attributed to lack of breast cancer awareness amongst women, resulting in them seeing their doctor at a later stage. To improve the chance of cure, the disease should be diagnosed as early as possible.

It has been suggested that breast cancer in Asians present at a younger age and tends to be more aggressive. Findings appear to confirm that breast cancer features in Asians are of the more aggressive type compared to the Caucasians. However, further comparative studies are required and already planned to evaluate the differences between the two groups (Asian and Caucasian breast cancer).