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Breast Cancer In Canada, 2016

 
OVERVIEW
1 in 9 women in Canada is expected to develop breast cancer during her lifetime (by the age of 90)  

In 2016, breast cancer continues to be the most common cancer diagnosis in Canadian women – with 1 in 4 (25.8%) cancer diagnoses being breast cancer. It is the second leading cause of cancer deaths in Canadian women, after lung cancer.

Fewer Canadian women are dying from breast cancer today than in the past. Breast cancer deaths have decreased by 44 percent since the peak in 1987 due to earlier detection through regular mammographyMammogram (also called mammography):
A low-dose X-ray of the breast. It is used to take images of the breasts and is an important screening tool for the earlier detection of breast cancer.
screening, advances in screening technology, and improved treatments. This is based on the age standardized mortality rates (ASMR) which has declined from 41.7 deaths per 100,000 in 1987 to a projected rate of 23.4 deaths per 100,000 in 2016, slightly down from 23.8 in 2015.

Incidence

Breast cancer incidenceIncidence (rate):
The number of newly diagnosed cases of a disease during a specific time period. Incidence helps us to understand the risk of developing that disease.
is the number of new cases diagnosed in a population over a period of time. It provides an understanding of the risk of developing breast cancer, and is different than breast cancer prevalencePrevalence:
The number of people living with a disease in a population at a particular point in time.
, which is the number of people living with breast cancer in a population at a particular point in time.

Incidence of Breast Cancer in Canada

In 2016, an estimated 25,700 Canadian women will be diagnosed with breast cancer. This is equivalent to 130.1 cases per 100,000 women. Breast cancer continues to be the most commonly diagnosed cancer in Canadian women, representing 26 percent of all newly diagnosed cancers in women.

Breast cancer incidence rates in women are generally consistent across Canada, and do not vary significantly by province or territory. Breast cancer incidence rates have remained relatively stable since the late 1980s, though the actual numbers diagnosed each year are increasing due to population growth.


New breast cancer cases diagnosed in Canadian women 2016 (#)
​Annually ​25,700
​Weekly (average) 494
​Daily (average) ​70
​Hourly (average) 3​


Breast Cancer Incidence and Age

The risk of being diagnosed with breast cancer increases with age. In 2016, it is estimated that 83% of new breast cancer cases will would occur in Canadian women over the age of 50:

  • 51 percent of breast cancers will be diagnosed in women 50 to 69 years of age

  • 32 percent of breast cancers will be diagnosed in women over the age of 69

  • 17 percent of breast cancers will be diagnosed in women less than 50 years of age (with most of these, 13%, occurring 40-49).

BreastCancer_2015NewCasesDiagnosed.png

​​Estimated new breast cancer cases diagnosed in Canadian women by age group in 2016
​Age Group
​# of new cases
​% of new cases
​0-19
5 0.02%
​20-29 ​140 ​0.54%
​30-39 ​1,050 ​4.09%
​40-49 ​3,300 ​12.84%
​50-59 ​6,200 24.13%​
​60-69 6,900​ 26.85​%
​70-79 ​4,900 ​19.07%
​80+ ​3,200 ​12.45%
​Total ​25,695 ​100.00%

Breast cancer by Province

An estimated 25,700 Canadian women will be diagnosed with breast cancer in 2016. While the ratio of diagnoses remains similar across provinces, the actual number and proportion of diagnoses in each province varies (due to population size). Ontario has the largest proportion of breast cancer cases in Canada, at 39 percent.

​​Estimated new breast cancer cases in women by province in Canada in 2016 
​Canada BC AB SK​ MB​ ON QC NB​ NS​ PE​ NL
# ​25,700 * ​3,500 2,400​ ​720 880​ 9,900​ 6,300​ 570​ 790​ 120​ 440​
% ​100% * ​13.6% ​9.3% ​2.8% ​3.4% ​38.5% ​24.5% ​2.2% ​3.1% ​0.5% ​1.7%


* Territory numbers not provided due to small numbers. Column totals may not sum to row totals due to rounding. Canada totals include provincial and territorial estimates.

Breast Cancer Prevalence

Breast cancer prevalence is the number of people living with a new or previous breast cancer diagnosis in a population at a particular time. Most recent data (2009) suggests that more than 157,000 Canadian women, and over 1,000 Canadian men, who had a breast cancer diagnosis since 1999 were living.

Breast Cancer Survival

The five-year relative survival ratio gives an ‘average’ indicator of survival (up to 5 years) after a breast cancer diagnosis in a group of people, but does not reflect an individual person’s prognosis. It also does not distinguish between women living with breast cancer (or another disease) and those who are healthy.

Most recent data indicates that the five-year relative survival ratio for breast cancer is 87 percent, meaning that 87 percent of women diagnosed with breast cancer 5 years ago are living. This number has been relatively stable for the past several years. In 1987, when breast cancer mortality was at its peak, the relative survival ratio was 79 percent.

BreastCancer_2015RelSurvivalRate.png 

The all ages 5-year relative survival ratio is 87%


*Data from Quebec were excluded, in part, because the method for ascertaining the date of cancer diagnosis differs from the method used by other provinces and territories and because of issues in correctly ascertaining the vital status of cases.

Women who are diagnosed between the ages of 40 and 69 have the highest 5-year survival rates (89-90%) and lowest rates are among women 80-99 (78%). There is little provincial variation for breast cancer survival.

More women, of all ages, are living longer after a breast cancer diagnosis due to advances in the earlier detection, diagnosis and treatment of breast cancer. The five-year relative survival ratio does not, however, show survival more than 5 years after diagnosis.

Breast Cancer Mortality

Mortality refers to the number of people that are likely to die from breast cancer in a population over a period of time.  Mortality rates can help us understand the impact that breast cancer has on society based on the number of lives lost to the disease. They also provide insight into the effectiveness of treatments.  High incidence rates and low mortality rates suggest that while a significant number of people are being diagnosed with a disease, many are surviving due to effective treatments.

In 2016, an estimated 4,900 women will die of breast cancer in Canada. This is the same number of estimated deaths as in 2014. Breast cancer remains the second leading cause of cancer death in Canadian women, accounting for 13 percent of all cancer-related deaths. The proportion of women dying from breast cancer has been dropping incrementally over time. The leading cause of cancer deaths in Canadian women continues to be lung cancer.

Breast Cancer Mortality Rates in Canada 2016 (#)
​Women who will die of breast cancer, annually 4,900
Women who will die of breast cancer, weekly (average) 94
​Women who will die of breast cancer, daily (average) 13

 

Breast Cancer Mortality and Age

The risk of dying from breast cancer increases with age. 91 percent of breast cancer deaths occur in women 50 and over; the majority of breast cancer deaths (52 percent) occur in women over 70 years of age.

Women under the age of 50 represent 17 percent of breast cancer cases (4 percent under 40) – and account for 9 percent of breast cancer-related deaths (2 percent under 40). Generally, breast cancer mortality rates in women are consistent across Canada and do not vary significantly by geography. 

Breast Cancer Statistics - Estimated Deaths 

Fewer Canadian women are dying from breast cancer today than in the past. In fact, the breast cancer mortality rate in Canada is the lowest it has been since 1950. Breast cancer mortality rates have decreased by 44 percent since the peak in 1986 due to earlier detection through regular mammography screening, advances in screening technology, and improved treatments.

The significant decline in the breast cancer mortality rate suggests that there has been important progress made in cancer control. Cancer control aims to reduce the expected number of new diagnoses, reduce the severity of illness, enhance the quality of life for those diagnosed, and reduce the likelihood of dying from the disease. In relation to breast cancer, advancements in earlier detection are an aspect of cancer control efforts that have been particularly successful. When women are diagnosed at earlier stages of the disease, more treatment options are available, and women have a better chance at surviving the disease.

While over half of the new cases of breast cancer will occur in women between ages 50 and 69, more deaths from breast cancer will occur in women 80 years of age or older than in any other age group.

Breast cancer in younger women (under age 50)

The burden of breast cancer affects younger women to a greater extent than older ones. It is estimated that in 2016, in women over 60, only 12 percent of cancer related deaths are due to breast cancer. In women 30-59, however, fully 22 percent of cancer related deaths are due to breast cancer.  Breast cancers in younger women tend to be more aggressive, often moving quickly to advanced stages.  

An estimated 4,495 (1749 percent) new cases of breast cancer in Canada will be diagnosed in women under 50 in 2016.  Nine percent (460) of all breast cancer deaths will be in women under 50. To put this in context, lung cancer – the only cancer with a higher mortality rate for women overall than breast cancer – is responsible for only 195 deaths in this age group.

It is important to note that women under the age of 50 are not consistently targeted for breast cancer screening across the country. There has been an increased focus on early detection and screening for women that have been determined to be at high risk.

The 5-year relative survival ratio for women under 40 years of age is improving over time, and is currently at 85 percent. The 5-year relative survival ratio for women 40-49 years of age is 90 percent. The average 5-year relative survival ratio for women of all ages is 87 percent, with a range of 76 to 91 percent across all ages (78 percent for women 80-99).

Breast cancer in men

In 2016, an estimated 230 men in Canada will be diagnosed with breast cancer. Men with breast cancer make up 0.9 percent of all breast cancer cases, and 0.2 percent of all cancer cases in men. Breast cancer in men is not well understood, is stigmatizedStigma:
The shame attached to something seen as socially unacceptable. For men with breast cancer, there may be a greater sense of embarrassment about a breast cancer diagnosis because it is often thought of as a woman’s disease.
, and can be misdiagnosed or diagnosed when the cancer is in the later stages of disease. 

Men are on average older when they are diagnosed. Men diagnosed with breast cancer have a 79 percent likelihood of living for five years after their diagnosis. The difference between five year relative survival between men, at 79 percent, and women, at 87 percent, is in part due to the fact that men tend to be diagnosed when the disease is more advanced and fewer treatment options are available.

Research has found that men are often less likely to survive the disease than women because they are diagnosed with a more advanced stage of the disease, and the treatment of male breast cancer is based on those developed for women. In 2016, 55 Canadian men are expected to die from breast cancer.

The Future Burden of Cancer

Breast cancer incidence rates in Canada increased in the late 1980s, partially due to the increase in mammography screening, which meant that more breast cancers were being detected. Since then, there have been slight changes in the incidence rate related to factors such as increased use of hormone replacement therapy, which is associated with increased breast cancer risk. Overall, the breast cancer incidence rate has remained relatively stable since the late 1980s.

Breast cancer mortality rates in Canada were at their highest in 1986, and have decreased by 44 percent since then as a result of increased and better screening technologies, as well as improved treatments. This represents a small, but positive change from 2012 statistics, which quoted a 39 percent reduction in deaths since 1986. More women who are diagnosed with breast cancer are living for at least 5 years after diagnosis, with a 5-year relative survival ratio of 87 percent. This number has increased only modestly over the past 20 years (from 82% in 1992 to 88% since 2011).

Taken together, the current figures on incidence, prevalence and mortality of breast cancer tell an important story about the connections between age and cancer. While the incidence (as reported here, anticipated number of new cases of breast cancer diagnosed in 2016), prevalence (number of cases of breast cancer in the population), and mortality (deaths due to breast cancer) are all highest in women over 50,  generally speaking, the group of diseases known as cancer are more common in older age groups. That is, the proportion of total deaths due to cancer is naturally going to be higher in older populations, because incidence of cancer is higher in older populations.

While breast cancer incidence rates have stabilized, and mortality continues to incrementally decline, breast cancer remains the most commonly diagnosed cancer in Canadian women, and the second leading cause of cancer-related death. Further, it appears that breast cancer will likely continue to be a major contributor to the burden of cancer in future. According to Statistics Canada, it is expected that from the mid-2000s to around 2030, the Canadian population will grow by 29 percent: 9.5 million people. Also during this period, the proportion of Canadians aged 65 and older is projected to change from 1 in 8 to 1 in 4. The aging Canadian population has implications for a health system which must support Canadians with a finite pool of resources. And, breast cancer is expected to remain one of the four most diagnosed forms of cancer, along with prostate, lung, and colorectal. Female breast cancer cases are expected to increase from 20,110 in the mid-2000s to 31,255 new cases around 2030, representing a 55% increase in cases from then until 2030.

Given these projections, health system planners have an opportunity to mitigate the future burden of cancer by developing more effective strategies for prevention, treatment, and early detection of cancer. For breast cancer, this could mean:

  • an increased focus on public education and engagement to increase awareness about how women can take action to reduce their risk of breast cancer

  • ongoing development of more efficient and effective screening and diagnostic technologies to detect breast cancers earlier, when more treatment options are available

  • innovative approaches to cancer risk stratification to ensure that health care resources are better utilized - for example by offering more frequent screening to women at high risk of breast cancer, and less frequent screening to women at low risk

  • Better, more targeted treatments to see more women with breast cancer achieve better outcomes with less time away from families and work.

 

Sources:

With the exception of citations below, all information within the document is sourced from:

Canadian Cancer Society's Advisory Committee on Cancer Statistics. Canadian Cancer Statistivs 2016. Toronto, ON: Canadian Cancer Society; 2016. www.cancer.ca/statistics

Rizzolo, P; Silvestri, V; Tommasi, S; Pinto, R; Danza, K; Falchetti, M; Gulino, M; Frati, P; Ottini, L. (2013, Nov) Male breast cancer: genetics, epigenetics, and ethical aspects. Annals of Oncology. Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/24131976

American Cancer Society. What are the risk factors for breast cancer in men? Last revised Feb 26, 2013.

Greif, JM; Pezzi, CM; Klimberg, VS; Bailey, L.; Zuraek, M. (2012, May) Gender Differences in Breast Cancer: Analysis of 13,000 Male Breast Cancers from the National Cancer Data Base. Abstract presented at the American Society of Breast Surgeons 13th Annual Meeting, Phoenix, AZ. Abstract retrieved from http://www.breastsurgeons.org/presskit/docs/2012_MALE_BR_CA_video.pdf