Breast Cancer and Women in our Military

In doing research this past week, I came across a press release issued by Congressman Leonard Boswell’s office concerning the high incidence of breast cancer diagnoses in women on active duty in our military forces.

An excerpt from the May 24, 2011 release reads as follows:

Washington, DC – Today, Congressman Leonard Boswell submitted an amendment to the House Rules Committee for the National Defense Authorization Act that would commission a study on the incidence of breast cancer in members of the Armed Forces and veterans, and analyze contributing factors. The Rules Committee will consider the amendment tonight.

“There is significant anecdotal evidence that men and women who are serving or have served their country bravely are being diagnosed with breast cancer at an alarming rate, especially for their age,” said Boswell, who introduced legislation on this issue in the 111th Congress. “This Act would require the Department of Defense and VA to take the first step to determining if breast cancer is service-connected.

This press release got me wondering what research had been done to date that studied the incidence of breast cancer diagnoses in women in the military. My first stop…the Department of Defense (DOD)for an overview of facts on our women in the military:

The majority (>90%) of women in active military service are < 40 years of age. The Department of Defense (DOD) with its high percentage of young women and its commitment to health care is particularly concerned about breast cancer. When discovered at a later stage, treatment of breast cancer is expensive, aggressive and results in considerable disruption to the woman’s ability to contribute to society. Cost and disruption to life are considerably less when the carcinoma is discovered at an earlier stage. Furthermore, the DOD has a high percentage of African-American (~40%) and Hispanic (~10%) women. Death rates from breast cancer tend to be particularly high in these ethnic groups owing in part to later stage of detection and to the more aggressive nature of breast cancer in these groups.

The active duty military force is approximately 20% female. Most of these service members are in the age range (30-40 years) where routine screening for breast cancer consists only of clinical breast examination. Both mammography and clinical breast examination have a very poor accuracy in the young active duty force in determining which breast abnormalities require treatment, and which are benign and can be left alone. The immense scale and impact of this problem for the military can be assessed by the fact that there were over 2,000 cases of breast cancer diagnosed in active duty service members over the last ten years (source: ACTURS DoD Tumor Registry data).

Furthermore, there were over 8,000 unnecessary breast biopsies done on active duty women during this time because it takes 4 breast biopsies of normal non-cancerous lesions to find each individual breast cancer. Hence, women often need to take lengthy amounts of time off from duty in order to undergo multiple tests leading up to the biopsy as well as time off from duty because of the biopsy itself.

This translates into approximately 10,000 weeks, or 30 person-years, of time lost in the evaluation of normal, benign breast lesions in active duty service members. This would be unacceptable for any other healthcare issue, and should be so for this one. Unfortunately, at the present time there is absolutely no screening tool currently available to diagnose breast cancer in the early, curable stages for women under the age of 40, who make up the vast majority of women in military uniform.

I also found several references to a June 2009  article in Cancer Epidemiology Biomarkers and Prevention. What follows are excerpts that address breast cancer in U. S. service women on active duty. The study found that:

  • The incidence rates of breast cancers were significantly higher in the military among Whites and Blacks. (Zhu,K et.al. Cancer Incidence in the U.S. Military Population: Comparison with Rates from the SEER Program,18(6). June 2009)
  • The potential differences in screening practices between the military and general populations, variations in some risk factors may have contributed to the higher breast cancer rates in the military.
  • With respect to breast cancer, military women may differ from those in the general population in reproductive history such as age at first birth and use of contraceptives.
  • Military women may be more likely to use oral contraceptive pills  As shown in our recent analysis, 34% of active-duty women and 29% of women in the general population used OC pills in the preceding twelve months. Oral contraceptive pill use has been demonstrated to increase the risk of breast cancer, particularly in younger women.
  • Military women are also more likely to be engaged in industrial jobs than females in the general population and hence potentially more likely to be exposed to chemicals that may be related to breast cancer
  • A study in military women showed that those aged 34 or younger had higher age-specific incidence rates of breast cancer than women in the general population and the incidence was higher among military women with a moderate to high exposure to volatile organic chemicals than those with low or no exposure

We can only hope that Congressman Boswell of Iowa is successful in getting his study on the high incidence of breast cancer in our military approved !

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10 Comments

  1. Maureen Brewster says:

    Great article. I am a 54 yr old active duty soldier who was diagnosed on 9 January with breast cancer stage 1.

  2. Dalene Harness says:

    I am a 53 year old navy veteran with stage 4 breast cancer which was diagnosed August 25, 2011.

  3. candos5 says:

    Hi Dalene,

    Thanks for writing! How are you doing? Are you getting the care you need through the veteran’s health care system?
    If you are, would you want to make readers aware of the level of care available to our veteran’s?

    Please keep in touch.

    Best,

    Jean

  4. Dalene Harness says:

    Jean,

    I am doing OK. Thank goodness for the VA. The VA has been wonderful and the doctors and nurses are great at Overton Brooks VA Medical Center in Shreveport, LA. I have had a positive experience going to the VA. I wish others could receive the level of treatment that the VA offers.

    Dalene

  5. KD says:

    I am a 11 year active duty commissioned officers and was recently diagnosed with breast cancer. This is an excellent article and a subject in which I was not aware of. Does anyone know the status of the amendment submitted by Congressman Boswell?

  6. candos5 says:

    Hi,

    Thanks for writing. I am sorry to hear of your breast cancer diagnosis. How are you doing? Unfortunately I have not heard anything more about Congressman Boswell’s amendment.

    If you want to share your story, I will publish it as a guest post. I am sure other servicewomen will benefit from your experience. If so, please email me at jean@noboobsaboutit.org.

    All the best,

    Jean

    Jean

  7. KD says:

    Thank you for your kind words of support. I sent you an email.

  8. KD says:

    Good news the bill by Congressman Boswell was reintroduced in May 2012. The passing of this bill will require the Secretary of Defense and Secretary of Veterans Affairs to collaboratively study the breast cancer incidence rate among service members and veterans. Lets see what happens this go-round.

  9. Lou says:

    Im very interested in knowing more about this bill and the study. I was 8 years in the Navy working with/on aircraft and exposed to toxic chemicals as well as deployed to Kuwait for OIF/OEF from ’05-’06. I was medically discharged and found a paper in my medical record stating that I was exposed to unknown chemicals while deployed. However, I was never informed of the exposure. I am now having to “deal with” the VA for medical issues with my breasts and lymph nodes. Not sure what my diagnosis will be but it’s a long horrible process and the VA does not have any sense of urgency. I wish I could say wonderful things about the VA but I can not. My experience has been a horrible comedy of errors. Please, keep us updated on what you find.

  10. Meredith says:

    After reading an article in the Army Times concerning breast cancer in the military, I started doing some internet research & came across this article. I served 10 years in the Army, 2 deployments to Iraq. I got out in 2008. This past March I discovered a lump. I had a mammogram & biopsy done. Thankfully it was benign. There is no history of any kind of cancer in my family. I hope the powers that be will do more research into this.

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