Breast Cancer

Once assessment and planning have been completed, including analysis of the collected data, the next step is implementing the strategies and interventions that will comprise the workplace health program. The intervention descriptions on this page include the public health evidence-base for each intervention, details on designing interventions for breast cancer screening, and links to examples and resources.

Multi-component interventions that include communications/media, education, reduction of barriers, and enhanced access to care will increase employees’ awareness of and participation in screening, prevention, and treatment.

Before implementing any interventions, the evaluation plan should also be developed. Potential baseline, process, health outcomes, and organizational change measures for these programs are listed under evaluation of breast cancer screening programs.

Breast cancer is the second most common cause of cancer deaths among adult women.

• In 2007, 202,964 women were diagnosed with breast cancer, and 40,598 women died as a result of breast cancer¹
• Women aged 40 to 64 years accounted for 61% of in situ cases, 54% of invasive breast cancer cases, and 40% of breast cancer deaths in 2005.² The direct medical care costs for breast cancer treatment were estimated to exceed $6 billion in 1996³

The United States Preventive Services Task Force recommends:

• Women aged 50-74 years should receive screening mammography, with or without clinical breast examination, every 2 years. Mammography screening is a valuable early detection tool that can identify breast cancer at an early stage when treatment is more effective and less expensive
• For women younger than 50 years of age, the decision to start mammography screening should be made in consultation with their physician and take into consideration such factors as family history and general health
• Women whose family history is associated with an increased risk of “breast cancer genes (mutations in BRCA1 or BRCA2 genes)” should be referred for genetic counseling and evaluation for BRCA testing
• Against routine referral for genetic counseling or routine breast cancer susceptibility gene (BRCA) testing for women whose family history is not associated with an increased risk for breast cancer genes
• Clinicians should discuss chemopreventive medications, such as tamoxifen, with women at high risk for breast cancer and at low risk for adverse effects of preventive medication use

Screening mammography refers to mammography used as part of a regular preventive services plan and not to mammograms used to follow up on abnormal radiologic or physical findings. The U.S. Preventive Services Task Force (USPSTF) recommends screening mammography, with or without clinical breast examination (CBE), every 2 years for women aged 50-74 years.

In Rankings of Preventable Services for the U.S. Population, the Partnership for Prevention provides an approach to ranking preventive services according to their clinically preventable burden (CPB) and cost effectiveness (CE). CPB is the disease, injury and premature death that would be prevented if the service were delivered to all people in the target population. With this approach, mammography screening received a ranking of 6 on a scale of 1-10, with 10 the highest ranking.