Ahead of the Breast Cancer Awareness Month observed in Israel and worldwide during the month of October, the Israel Cancer Association in collaboration with the Ministry of Health, published the updated breast cancer statistics in Israel.
The statistics collected by the National Cancer Registry at the Ministry of Health shows that 23,583 women diagnosed with breast cancer during 2013-2017 live in Israel today and have survived or are still coping with the disease. Of those, 20,825 were diagnosed with invasive breast cancer and 2,758 were diagnosed with cancer in situ.
Moshe Bar-Haim, ICA Director General: “This is an opportunity to remind everyone pf the importance of maintaining a healthy and active lifestyle. About one-third of all breast cancer cases are preventable by adopting healthy habits such as maintaining a healthy weight, physical exercise, breastfeeding, refraining from smoking and alcohol. Researches show that physical exercise is related to a lower risk of developing breast cancer and helps cope with the treatments. Simultaneously, women must get checked according to age-based guidelines, know their body and its normal condition, so that if a change occurs, it is important they consult their physician immediately to inquire about it."
Prof. Lital Keinan-Boker, Director of the Israel Center for Disease Control at the Ministry of Health explains: “In 2017, invasive breast cancer comprised about one-third of the total invasive tumors in women (32.0% in Jewish and “other” women[1], and 29.8% in Arab women). In total, 4,649 new patients were diagnosed with invasive breast cancer, 4,254 of them Jewish and other (92%) and 395 Arab (8%).
According to her, the majority of morbidity – both with invasive breast cancer and in situ – is in women over 50; the highest risk was observed in the older age group, and is usually higher in Jewish and other women than in Arabs.
[1] "Other" – Non-Arab Christians and those with no religious affiliation
Due to the complexity of data gathering, the newest National Cancer Registry data refers to 2017, and is the most updated as of today.
Breast cancer comprises about one-third of all newly diagnosed cancer cases each year in all women: it is the most prevalent malignant disease amongst women in all population sectors in Israel (Jewish and other, Arab). In 2017, 5,279 new patients were diagnosed with breast cancer; 4,649 (88%) were diagnosed with an invasive tumor and 630 in situ.
The temporal trend of incidence – the number of Jewish women newly diagnosed with invasive breast cancer during 1996-2017 has been stable: in Arab women, a significant increase of 1.7% was seen in during the entire period, most likely as a result of adopting a Western lifestyle, giving birth at an older age, having less children, less breastfeeding, a relatively high BMI, a poorer diet, etc.
The temporal trend of in situ breast cancer incidence (very early stage) during 1996-2017 showed a significant increase in all population groups: In Jewish women and others, the increase rate during 1996-2000 was 11% annually, and narrowed down to 2.2% per year in the following years of 2000-2017; in Arab women, the increase rate was 3.3% annually during the entire period.
The percentage of women diagnosed with an early stage of breast cancer (in situ or localized) was 66% in 2017 (58% in 2005); the percentage of women diagnosed with metastasized breast cancer was the same in 2017 and in 2005 (3.6%). Morbidity rates are mostly amongst women age 50 and over – both invasive breast cancer and in situ: the highest risk in women was seen in older age groups, and is usually higher amongst Jewish and “other” women than in Arab women. In the younger age groups, incidence rates were similar between the various population sectors.
As of today, 23,583 women living in Israel and diagnosed with breast cancer during 2013-2017 have recovered or are still coping with the disease.
The relative five-year breast cancer survival rate in Israel in women diagnosed during 2007-2011 is relatively high: 90% amongst Jewish women and 84% amongst Arab women. The equivalent rates for those diagnosed during 1996-2000 were 84% and 73%, respectively.
In 2017, 1,078 women died of invasive breast cancer in Israel. This is the most prevalent cause of cancer mortality in women, constituting about one-fifth of all cancer mortality in Jewish and “other” women and Arab women. The majority of mortality is in older age groups. About 13% of the total deceased (142 women) were younger than 50 upon death.
According to the World Health Organization (WHO) statistics for 2018, breast cancer is most prevalent cancer in women worldwide in terms of incidence and mortality. Compared to countries with the highest rates in the world, Israel is ranked 26 in breast cancer incidence, and 64 in mortality. Early detection and up-to-date treatments have led to an improvement in recovery rates and a decline in mortality rates. According to the Ministry of Health’s National Cancer Registry, thanks to the early detection national program initiated by the Israel Cancer Association - the number of women diagnosed with early stage breast cancer (in situ, or with local invasion only) continues its upward trend: in 2017, 66% of all new patients were diagnosed at an early stage (in situ or localized), and 64% in 2016, versus 58% in 2005. The percentage of the new patients diagnosed with localized breast cancer spread to local tissue and/or lymph nodes (LABC) was 31% in 2017 (32% in 2016 and 38% in 2005). The number of women diagnosed with metastatic breast cancer was similar in 2017 and in 2005 (3.6%).
Early detection by means of a screening program has proven to reduce breast cancer mortality and allow for change in the course of the disease. The program was initiated in Israel in the 1990’s by the Israel Cancer Association, and has been implemented ever since in collaboration with the Ministry of Health and all the health care funds, based on clinical research findings and guidelines by professional bodies.
As part of the national screening program, the ICA purchased its first Mobile Mammography Unit, 'Michal', in 2001, with the aim of raising compliance amongst women in geographical and social peripheries with mammography examination. Since the mobile mammography unit began operating, its importance has been proven in significantly minimizing the gaps in compliance rates between the various population groups, such as ultra-Orthodox and new immigrant women, and completely eliminating the disparities between Jewish and Arab women. At this time, Israel is a global leader in mammography compliance rates, while continually bridging the gaps, and ranks amongst the leading countries in breast cancer recovery rates.
In 2019, approx. 19,000 screening tests were performed in social and geographical peripheries, as part of the mobile unit’s activity across the country. The mobile unit is operated by Assuta Medical Services and provides services to insureds of all healthcare funds.
Maintain a healthy, active lifestyle: a third of all breast cancer incidence can be prevented by adopting a healthy, active lifestyle. Studies have shown that there is a link between physical activity and a decline in the risk of developing breast cancer, mainly after menopause. Physical activity reduces the risk of developing breast cancer, independently of the risk factor related to body weight.
Avoid adopting behavioral patterns that may increase the risk of developing breast cancer: refrain from smoking, lack of physical activity, obesity and alcohol consumption, which have been proven to increase the risk of developing breast cancer.
Breastfeeding: it has been scientifically proven that breastfeeding reduces the mother’s risk of developing breast cancer. Aside from the baby’s health, this is another reason why breastfeeding is recommended.
The ICA produces and distributes a complimentary brochure "Choosing Healthily – Breast Health is in Your Hands" (in Hebrew), which includes recommendations for women on reducing breast cancer risk factors and coping with the disease. Click here to order informational materials.
Mammography Screening for Women between the ages of 50-74
Important to know:
The BRCA1/2 genetic mutation test for healthy Jewish women whose parents are both of Ashkenazi background (even without family history) was added to the 2020 technology and drug basket.
Click here for the interactive questionnaire on genetic diagnosis and consultation – as part of the Prevention Generation program (in Hebrew)
The ICA runs the Forum for Breast Cancer and Genetic Carriers and Women in High Risk of developing Breast and Ovarian Cancermediated voluntarily by top professionals. Click on the links to enter the forums.
Men rarely develop breast cancer (1% of the total breast cancer patients). According to statistics, about 50 men are diagnosed with breast cancer each year. The cause for breast cancer in men is yet to be determined, but it seems that some men are at an average risk of developing breast cancer. The main risk factors are age 60+ and having close family relations (men or women) that had or are currently coping with breast cancer. Men at high risk should ask their healthcare fund physician for referral to genetic counselling. Currently, there is no recommendation for healthy men at normal risk to undergo early detection. Men who are gene carriers may pass on the mutation to their daughters.
A new radio infomercial – the ICA produced a new infomercial ahead of breast cancer awareness month titled, "Sometimes even the slightest sensation or change has meaning. Get checked," curtsey of Gitam BBDO advertising agency, who produced the infomercial voluntarily. The important message behind the infomercial is that at any age and any state, if you feel a lump or a change in your breasts, it is important to consult your physician and inquire about it. The infomercial completes an advertisement that carries a similar message. Voice over curtesy of Gali Shtarkman.
"A Drop" infomercial for raising awareness to breast cancer, was translated into Arabic as the video featuring the ICA mobile unit. Both will be features on the digital media in Arabic.
WhatsApp stickers – for the first time ever, the ICA created stickers that are not humorous or emoji-like but carry a life-saving message. The sticker comes with message: "there is a cool sticker, a funny sticker, and a life-saving sticker," reminding the public of the importance of seeing a physician should a lump or a change in your breasts is felt.
Survivors towards a Healthy Life® is an ICA project which offers workshops for BC survivors, their partners and families. The aim of these workshops is to help cancer survivors cope with the aftermath or trajectory of the disease, enhance their quality of life, provide them with tips on how to lead a healthy life, and encourage them to return to their normal personal routine and active community life. The series of sessions are led by professionals on various topics such as returning to routine and family, intimacy and sexuality, health after recovery and coping with side effects, personalized diet during and after the disease and integrative medicine for patients and survivors. Special workshops are held for breast cancer survivors.
Steps to a Healthy Life® is an ICA project aim of this workshop is to help cancer survivors cope with the aftermath of the disease, enhance their quality of life, provide them with tips on how to lead a healthy life, and encourage them to return to their normal personal routine and active community life. Expose cancer patients to the healthy advantages of physical activity. Encourage cancer patients to build time in their schedule for planned, structured physical activity and make it part of their daily routine. Offer consultation and guidance to patients who wish to join. Provide workshops that are held at the various medical centers and ICA branches in the community. The project is led by Prof. Naama Constantini, a Sports Medicine Specialist at Hadassah Optimal's Sports Medicine Center.
Look Good, Feel Better® is an ICA project (operating in a downsized, personalized scale during the Coronavirus period) offering patients beauty care, hair and wig care and consultation services free of charge in over 40 medical centers and in the community, to lift their spirits, make them feel better and help them cope with the disease and its side effects. Female patients from all over the country receive beauty care treatments and guidance on how to care for/adjust their hair or wigs so that they can look better and consequently feel better. The beauty professionals arrive at oncology centers, outpatient centers and the ICA Home Hospice service. Over 4,000 men and women participate in this project every year.
Click here for more information about the project.
The ICA runs a variety of activities and provides many support service to women coping with breast cancer, such as support group for patients, their partners and more. More information about free, breast cancer related services can be found in the "With You and For You" brochure on the ICA website.
Women interested in support as well as breast cancer survivors interested in volunteering are invited to contact "Yad Lehachlama"® (Reach to Recovery) program hotline at 1-800-36-07-07 or by clicking the pink button on the ICA website.
"Yad Lehachlama" (Reach to Recovery) is a national volunteer program of women who coped or are coping with breast cancer. The program was founded in 1967 by the Israel Cancer Association and consists of about 250 women nation-wide, young and older, Jewish and Arab, and multilingual, who stand by new patients throughout all stages of diagnosis, coping and keeping a daily routine, as well as advanced breast cancer patients. They are assigned to each patient according to similar demographic statistics, type of treatment and language, and help them through various dilemmas by providing information and offering emotional and practical support based on their own personal experience.
The ICA runs the Breast Cancer Forum and the Forum for Genetic Carriers and Women in High Risk of Developing Breast and Ovarian Cancer, a professional online forum run by Prof. Efrat Levy-Lahad and Dr. Shlomit Perry. Prof. Levy-Lahad, head of the Genetic Institute at Shaare Zedek Medical Center, coordinates the Israel Genetics Consortium initiated and assisted by the Israel Cancer Association in 12 medical centers. Important studies have been published in professional literature worldwide based on the consortium's work.
The ICA runs a support group for healthy, genetic women carriers/at high risk of breast and ovarian cancer. For more information, contact the ICA Rehabilitation and Welfare Dept. at +972-7521678 or Shikum@cancer.org.il
Sexuality consultation: The ICA provides one-on-one, free of charge sexual consultation for patients and survivors, and their partners, as well as single patients by a sex therapist. The consultation addresses the effects of cancer on sexuality and fertility, as well as intimacy and body image. It also provides information regarding options for treatment and rehabilitation of sexual functioning. The service is free of charge does not require a referral and is provided by the ICA's sex therapist. For more information, contact +972 -3-5721638 or miniut@cancer.org.il
Women who complete their breast cancer chemotherapy and radiotherapy treatments often find themselves at a loss. The expectation that the side effects they experienced will subside, and that they will be able to resume a normal life right away most often doesn't materialize. In addition, the intensive support system of the treatment framework is no longer part of their life. Many of them also receive hormonal treatment, which adds to the changes in their life and poses a real challenge in their coping. As a result, many experience a deep personal crisis – physical, emotional and social – at this stage in their trajectory.
A research funded with ICA's assistance and conducted by Dr. Yakir Rothenberg from Hadassah Ein Karen Medical Center shows that breast cancer patients within working age were employed even 10 years following their diagnosis.
Many studies show and reinforce the fact that physical activity helps significantly in coping with the side effects of treatments, and raises cancer patients' survival chances in general and breast cancer patients in particular (who are more prone to morbidity throughout life than healthy women). Regular, balanced physical activity combined with proper nutrition increases energy, releases tension, encourages appetite, reduces fatigue and pain, reinforces positive self-esteem, improves mood and ability to function, and above all – helps greatly in reducing side effects of treatments and the risk of disease recurrence.
"The Day After" program, which runs in collaboration with the oncology institute at Shaare Zedek Medical Center, the Rothberg Sports Center of Shaare Zedek at Arena Pais Jerusalem and the ICA, was founded in order to help address the needs of women coping with breast cancer during the treatment phase.
According to testing and questionnaire results – impressive changes were recorded at the end of the program compared to its onset: considerable improvements were detected in physical fitness measures, including pressing power, walking and percentage of bodily fat. A considerable improvement was also recorded in the patients' quality of life upon completion of the program. That included improvement in fatigue, pain, mood, self-image and more.