Why breast cancer is spreading around the world

Time Magazine ran an interesting article (Why Breast Cancer is spreading around the world - October 15 2007) recently looking at the increasing incidence of breast cancer in developing countries. One well-known fact is that breast cancer rates vary dramatically in different countries and societies. The rate is highest in developed industrialised nations such as USA (98 per 100000 people) and Australia and New Zealand are not far behind. Countries in Eastern Asia have rates of less than 40 per 100000) Equally interesting is the fact that women who migrate to live in a high risk country pick up the increased risk within a few years. This data would all suggest that the incidence of breast cancer has much to do with environmental and lifestyle factors.

While we have not yet found "the cause" for breast cancer we should be looking much more critically at these factors rather than concentrating all our efforts on finding a wonder drug or magic bullet to cure the disease once it develops. Why is the incidence increasing? Are there things that we can modify in our environment and in our lifestyle that could reduce our risk?

I wrote to the magazine in response and was pleased that they chose to publish the letter.

…..I was saddened by the conclusions of Kathleen Kingsbury in her article on breast cancer.(Time October 15 2007). Is the answer to the increasing incidence of breast cancer in developing countries really more mammograms and breast centres? Is it necessary to mobilise a medical army to combat the scourge of breast cancer? Surely we need to look at the compelling demographic data presented in the article and to draw the logical conclusion that breast cancer is primarily a consequence of a first world lifestyle. It is not inevitable that all first world Western women are destined to accept a 1 in 10 lifetime risk of breast cancer and that they all require lifelong screening. We owe it to our daughters to alter our life style based on increasing evidence that simple dietary changes, regular vigorous exercise and reduced alcohol consumption can significantly reduce the risk of breast cancer? We need to be thinking much more ambitiously as a society of prevention rather than early detection and escalation of the costly and disappointingly ineffective strategies cut / burn and poison that the conventional war on breast cancer has to offer.

Trevor Smith
Breast Surgeon
New Zealand

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