Education And Debate

Putting the risk of breast cancer in perspective

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7168.1307 (Published 07 November 1998) Cite this as: BMJ 1998;317:1307
  1. John P Bunkera, visiting professor,
  2. Joan Houghtona, senior lecturer, department of oncology,
  3. Michael Baumb, professor of surgery
  1. a Cancer Research Campaign and UCL Cancer Trials Centre, University College London Medical School, London W1P 8AN
  2. b Department of Surgery, University College London Middlesex Hospitals Trust, London W1P 7LD
  1. Correspondence to: Dr Bunker
  • Accepted 26 June 1998

Patients are frequently given the opportunity to participate in making decisions about their care. To assist them in making their decisions data that are as accurate and as complete as appropriate will need to be quickly available. These data will be needed not only by patients but also by their doctors. A life table constructed from regularly published statistics on national morbidity and mortality can be used to display the likelihood of developing or dying of a disease (a cumulative probability) at any given age. Such a life table may be a valuable tool in helping patients to make decisions about their care. In this paper we discuss the use of life tables to present to patients the absolute and relative risks of breast cancer and their use in comparing the risks from breast cancer with those from other life threatening conditions.

Summary points

A life table constructed from national statistics on morbidity and mortality can be a valuable resource in helping patients to make decisions about their care

Coordinating absolute and relative risks in a life table offers patients and doctors the opportunity to make more informed judgments

Life table analysis allows patients and doctors to estimate the cumulative probability of dying of breast cancer before a patient reaches a given age

The risk of developing or dying of breast cancer should be seen in the context of other life threatening conditions

For women who smoke the cumulative probability of dying of lung cancer matches that of dying of breast cancer when women reach their early 50s; this probability doubles by age 65 and triples by age 75

Cumulative incidence

Recently, notices in London's underground warned that women have a 1 in 12 risk of developing breast cancer. Women in America have been warned that their risk is 1 in 8; consequently, “fear …

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