Breast Cancer in Minnesota Women
INCIDENC E, MOR TA LI TY AND TRENDS
10/21/2020
i
Breast Cancer in Minnesota Women
Minnesota Department of Health
Minnesota Cancer Reporting System
PO Box 64882
St. Paul, MN 55164-0822
651-201-5900
health.mcrs@state.mn.us
www.health.state.mn.us
The collection of Minnesota Cancer data was supported by Cooperative Agreement Number, 1NU58DP006337
from the Centers for Disease Control and Prevention (CDC) The contents of this work are solely the responsibility
of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention
or the Department of Health and Human Services.
To obtain this information in a different format, call: 651-201-5900.
BREAST CANCER IN MINNESOTA WOMEN
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Contents
Breast Cancer in Minnesota Women .............................................................................................. 1
Introduction ................................................................................................................................ 2
Breast cancer .............................................................................................................................. 3
30-year incidence and mortality trends ..................................................................................... 4
Incidence has gradually increased since 2004 ........................................................................ 4
Mortality has decreased since 1988 ....................................................................................... 5
Breast cancer burden in 2017 ..................................................................................................... 6
Variations by age group, race/ethnicity and stage at diagnosis ................................................. 7
Breast cancer incidence and mortality increase with age ...................................................... 7
Breast cancer incidence and mortality by race/ethnicity ....................................................... 7
Breast cancer molecular subtypes ............................................................................................ 10
Surviving breast cancer ............................................................................................................. 12
Regional variations in Minnesota ............................................................................................. 14
Risk and protective factors ....................................................................................................... 16
Screening for breast cancer ...................................................................................................... 16
References ................................................................................................................................ 17
Data sources and methods ....................................................................................................... 19
Data sources .......................................................................................................................... 19
Minnesota cancer incidence data ...................................................................................... 19
Minnesota cancer mortality data ....................................................................................... 19
Surveillance, Epidemiology, and End Results (SEER) 9 Registries ...................................... 19
U.S. Mortality Data ............................................................................................................. 19
Population data .................................................................................................................. 19
Methods for data analyses ................................................................................................... 20
Analytic software ............................................................................................................... 20
Defining cancer statistics ................................................................................................... 20
Age-adjusted rate ............................................................................................................... 20
Unstable rate ...................................................................................................................... 20
Standard population .......................................................................................................... 20
Minnesota geographic divisions ........................................................................................ 20
BREAST CANCER IN MINNESOTA WOMEN
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Collecting and processing cancer incidence and mortality data .......................................... 20
MCRS authority and data protection ................................................................................. 20
Registry methods and standards ....................................................................................... 21
Glossary of terms ...................................................................................................................... 21
Cancer prevention resources .................................................................................................... 21
Comprehensive Cancer Control Program ............................................................................. 21
Minnesota Cancer Alliance ................................................................................................... 21
Sage Screening Programs ...................................................................................................... 21
Healthy Minnesota Partnership ............................................................................................ 21
Center for Health Equity ....................................................................................................... 22
Statewide Health Improvement Partnership ........................................................................ 22
Appendix ................................................................................................................................... 23
Table A1. 30-year breast cancer incidence and mortality rate (per 100,000) trend data,
1988-2017 ............................................................................................................................. 23
Table A2. Minnesota breast cancer incidence and mortality rates (per 100,000) by 5-year
age-groups, 2013-2017 ......................................................................................................... 24
Table A3. Minnesota breast cancer incidence and mortality rates (per 100,000) by
race/ethnicity, 2013-2017 .................................................................................................... 25
Table A4. Minnesota breast cancer incidence rates (per 100,000) by stage at diagnosis and
race/ethnicity, 2013-2017 .................................................................................................... 25
Table A5. Minnesota breast cancer incidence rates (per 100,000) by race/ethnicity, 2013-
2017 ...................................................................................................................................... 26
Table A6. Minnesota five-year relative breast cancer survival (percent) by stage at
diagnosis, 2010-2016 ............................................................................................................ 26
Table A7. Minnesota five-year relative breast cancer survival (percent) by race/ethnicity,
2010-2016 ............................................................................................................................. 26
Table A8. Minnesota five-year relative breast cancer survival (percent) by subtype, 2010-
2016 ...................................................................................................................................... 27
Table A9: Minnesota breast cancer incidence and mortality rate (per 100,000) trend data –
Twin Cities 7-County Metropolitan and non-Metropolitan counties, 1988-2017 ............... 27
Table A10. Minnesota state and county-level female breast cancer for incidence, mortality,
and prevalence, 2013-2017 .................................................................................................. 29
2
Introduction
The Minnesota Department of Health (MDH) is pleased to release Breast Cancer in Minnesota:
Incidence, Mortality and Trends. In Minnesota, breast cancer is the most common invasive
cancer diagnosed in women. It is also one of the top five cancer causes of death among
Minnesota women regardless of race or ethnicity. Breast cancers are easier to treat and
outcomes are often better when they are detected and treated early. Breast cancer screening
can identify cancers early and is a vital approach in the control of this cancer.
This report will serve as a timely and valuable resource to professionals throughout Minnesota
who are planning, developing or evaluating screening programs, patient navigation services, or
policy to prevent and control this cancer. MDH developed this report to support breast cancer
prevention and control efforts throughout Minnesota, including the Sage Program. For
information about these programs, see the Cancer Prevention Resources Section.
We present Minnesota’s long-term trends in breast cancer incidence and mortality against the
backdrop of long-term U.S. trends based on data from the National Cancer Institute’s
Surveillance, Epidemiology, and End Results (SEER) Program (seer.cancer.gov/data) and the
National Center for Health Statistics (www.cdc.gov/nchs/index.htm). We display patterns in
breast cancer incidence by age at diagnosis, race/ethnicity, stage at first diagnosis, and highlight
the state’s progress in meeting national Healthy People 2020 population targets for breast
cancer [1]. New to this report, we present Minnesota-specific statistics for five-year relative
survival and the incidence of breast cancer subtypes.
All charts and graphs are supported with detailed data tables in the Appendix. The Appendix
also includes a data table summarizing the burden of breast cancer at the state and county-
levels. Interested readers can seek additional state and county incidence statistics from the
Minnesota Data Portal Data Query [2]. This query allows users to generate county-level breast
cancer incidence rates for women by age groups (less than 50 and at least 50 years of age) as
well as for user-specified combinations of Minnesota counties.
BREAST CANCER IN MINNESOTA WOMEN
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Breast cancer
Breast cancer is the most common invasive cancer diagnosed in women across every racial and
ethnic group in Minnesota. It represents 30 percent of all new invasive cancers diagnosed in
women but it is a rare cancer in men. Invasive breast cancers spread beyond the cells where
they started and into surrounding tissue. Most breast cancers begin when abnormal epithelial
cells (or cells that line surfaces) in the breast grow out of control and form a tumor. Cancers
that arise in epithelial cells are called carcinomas. Lobular carcinomas start in the glands
(lobules) that make milk and ductal carcinomas start in the ducts that carry milk to the nipple.
There are at least four different breast cancer molecular subtypes that differ in their tendency
to grow, spread, and respond to treatment [3]. Knowledge of these subtypes informs decisions
about the therapies a woman will receive for her breast cancer [4], [5].
Outcomes are best when breast cancer is detected and treated early in the course of the
disease. Researchers are actively working to translate scientific advances about breast cancer
into new targeted therapies to improve outcomes for specific subtypes and for cancers that
have spread into distant sites beyond the breast (metastatic breast cancer) [3], [6], [7]. For
more information about breast cancer, go to American Cancer Society About Breast Cancer
(www.cancer.org/cancer/breast-cancer/about.html) [8].
BREAST CANCER IN MINNESOTA WOMEN
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30-year incidence and mortality trends
Incidence has gradually increased since 2004
As seen below (Figure 1, Appendix Table A1), incidence rates fluctuated in both Minnesota and
the Surveillance, Epidemiology, and End Results (SEER 9) region, with increases from between
1988 and 2000 and decreases from 2000 and 2004. Since 2004, breast cancer incidence rates
have been gradually increasing.
Figure 1. Breast cancer incidence has increased slightly since 2004
0
50
100
150
1985 1990 1995 2000 2005 2010 2015 2020
Minnesota SEER 9
Source: Minnesota Cancer Reporting System (1988-2017 Minnesota breast cancer age-standardized incidence rates). Surveillance,
Epidemiology and End Results (1988-2017 SEER 9 registries age-standardized breast cancer incidence rates for Connecticut,
Detroit, Atlanta, San Francisco-Oakland, Hawaii, Iowa, New Mexico, Seattle-Puget Sound, Utah). Rates are per 100,000 population
and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
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Mortality has decreased since 1988
Over the past 30 years, mortality from breast cancer declined an average of 2.4 percent per
year in Minnesota and 1.8 percent per year in the U.S. With few exceptions, mortality rates for
breast cancer among women have been consistently lower for Minnesota than for the US
(Figure 2, Appendix Table A1).
Figure 2. Breast cancer mortality rates have declined in Minnesota and the U.S.
0
5
10
15
20
25
30
35
40
1985 1990 1995 2000 2005 2010 2015 2020
Minnesota US
Source: Minnesota Department of Health Office of Vital Records (1988-2017 Minnesota age-standardized mortality rates).
National Center for Health Statistics (1988-2017 U.S. age-standardized mortality rates). Rates are per 100,000 population and
age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
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Breast cancer burden in 2017
In 2017, there were more than seven times as many new breast cancer diagnoses (4,643) as
deaths from breast cancer (627) for Minnesota women. About one in three of these newly
diagnosed breast cancers were late stage at the time of diagnosis. The age-standardized breast
cancer incidence rate in 2017 was 138.4 per 100,000 Minnesota women (131.6 per 100,000 in
the SEER 9 region). The mortality rate was 17.0 per 100,000 women (19.9 per 100,000 for the
U.S.) – below the Healthy People 2020 recommended target of 20.7 deaths per 100,000.
On January 1, 2017, an estimated 61,650 (or about 2.2%) women in Minnesota were living with
a prevalent breast cancer. Women with prevalent breast cancer include those who were newly
diagnosed with a breast cancer as well as women who were previously diagnosed and survived
their cancer.
The number of women with prevalent breast cancers in Minnesota provides important
information for those working to assure the health and well-being of those who survived their
breast cancer. Cancer survivors can experience a variety of acute [9], [10] and chronic [11]
health conditions due to their cancer and its treatment. Some serious chronic conditions among
breast cancer survivors include heart damage, osteoporosis, a second cancer, and others.
BREAST CANCER IN MINNESOTA WOMEN
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Variations by age group, race/ethnicity and stage at
diagnosis
Breast cancer incidence and mortality increase with age
Breast cancer incidence and mortality vary by age-group, race/ethnicity, and stage at first
diagnosis. Figure 3 (Appendix Table A2) shows that breast cancer incidence is much greater
than mortality at every age group. Incidence rates increase sharply after age 25, peak among
women ages 70-74 years, and then decrease among women ages 85 or more years. On the
other hand, breast cancer mortality rates increase slowly after age 40 years and continue to
increase with age.
Figure 3. Breast cancer incidence and mortality rates increase with age
337.9
437.8
489.3
524.9
438.9
351.2
261.6
236.3
203.8
128.6
64.2
31.5
10.6
1.6
0.1
0
0
0
Incidence
184.0
117.4
88.4
70.4
55.7
39.8
27.6
21.0
15.7
8.7
3.6
2.3
0.6
0
0
0
0
0
85+ years
80-84 years
75-79 years
70-74 years
65-69 years
60-64 years
55-59 years
50-54 years
45-49 years
40-44 years
35-39 years
30-34 years
25-29 years
20-24 years
15-19 years
10-14 years
05-09 years
00-04 years
Mortality
Source: Minnesota Cancer Reporting System (2013-2017 Minnesota breast cancer incidence rates). Minnesota Department of
Health Office of Vital Records (2013-2017 Minnesota mortality rates). Rates are per 100,000 population.
Breast cancer incidence and mortality by race/ethnicity
Compared to women of other races and ethnicities, White women have higher breast cancer
incidence rates but lower mortality rates. American Indian and Black women have the highest
mortality rates, followed by White women (Figure 4, Appendix Table A3). Asian/Pacific Islander
women have both the lowest breast cancer incidence and mortality rates in Minnesota. The
mortality rates for all of Minnesota’s racial and ethnic populations have reached the Healthy
People 2020 target of 20.7 deaths from breast cancer per 100,000.
There is wide variation in the incidence of early versus late stage breast cancer by
race/ethnicity (Figures 5 and 6, Appendix Table A4). Of note, the incidence of late stage breast
cancer for Black women remains greater than the Healthy People 2020 target of 42.4 late stage
breast cancers per 100,000.
BREAST CANCER IN MINNESOTA WOMEN
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Figure 4. Breast cancer incidence and mortality rates differ by race/ethnicity
135.1
101.8
106.8
78.2
102.5
0 20 40 60 80 100 120 140
White, Non-Hispanic
Hispanic - All Races
Black
Asian/Pacific Islander
American Indian/Alaska Native
Incidence rates
18.2
11.5
19.7
10.7
20.7
0 5 10 15 20 25 30
White, Non-Hispanic
Hispanic - All Races
Black
Asian/Pacific Islander
American Indian/Alaska Native
Mortality rates
HP2020 goal
Healthy People 2020 female breast cancer mortality rate target:
20.7 deaths/100,000
Source: Minnesota Cancer Reporting System (2013-2017 Minnesota breast cancer incidence rates). Minnesota Department of
Health Office of Vital Records (2013-2017 Minnesota mortality rates). Rates are per 100,000 population and age-standardized to
the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
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Figure 5. Incidence rates for early stage breast cancer by race/ethnicity
Source: Minnesota Cancer Reporting System (2013-2017 Minnesota breast cancer incidence rates). Rates are per 100,000
population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
Figure 6. Incidence rates for late stage breast cancer by race/ethnicity
Healthy People 2020 late stage breast cancer incidence rate target:
42.4 cancers/100,000 women
Source: Minnesota Cancer Reporting System (2013-2017 Minnesota breast cancer incidence rates). Rates are per 100,000
population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
89.6
64.0
59.0
50.0
63.3
87.3
0 20 40 60 80 100
White, Non-Hispanic
Hispanic - All Races
Black
Asian/Pacific Islander
American Indian/Alaska Native
All races
Early stage rates
42.4
34.4
46.1
28.0
37.3
42.0
0 20 40 60 80 100
White, Non-Hispanic
Hispanic - All Races
Black
Asian/Pacific Islander
American Indian/Alaska Native
All races
Late stage rates
HP2020 goal
BREAST CANCER IN MINNESOTA WOMEN
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Breast cancer molecular subtypes
Complex molecular and genetic information in cancer cells define different breast cancer
molecular subtypes. This information includes the presence or absence of receptors for certain
hormones (estrogen and progesterone) and for a factor that influences the growth of cells
(human epidermal growth factor receptor 2) [12]. Cancer cells can be hormone receptor
positive (HR+) or negative (HR-) as well as human epidermal growth factor receptor 2 positive
(HER2+) or negative (HER2-). The combination of a cancer’s HR and HER2 status determines, in
part, how fast a breast cancer will grow and how well it responds to therapy [13].
Cancer registries are currently able to collect information on four molecular subtypes of breast
cancer in populations [14]. Data at the population level can help inform planning for health care
services as well as research into the causes of breast cancer.
Table 1 below displays the age-standardized incidence rates for breast cancer subtypes in
Minnesota. Three of every four breast cancers with a known subtype in Minnesota are luminal
A (HR+, HER2-). This subtype responds well to hormonal therapies and has the best prognosis
[13, 14]. Compared to luminal A breast cancers, luminal B (HR+, HER2+) cancers grow and
spread more rapidly resulting in somewhat lower survival rates.
The triple negative subtype (HR-, HER2-) represents ten percent of newly diagnosed cancers in
Minnesota. This subtype is more common in Black and premenopausal women, and historically
has had poor prognosis [15]. Recent scientific advances show promise for improving outcomes
in women with triple negative breast cancer [3].
As seen in Table 1, less than one in twenty incident breast cancers are HER2-enriched (HR-,
HER2+). This subtype expresses growth promoting signals, resulting in aggressive growth, and
has shown a somewhat poorer prognosis compared to luminal A breast cancers.
Figure 7 (Appendix Table A5) displays Minnesota’s age-standardized incidence rates for the
luminal (A and B) and triple negative subtypes by race/ethnicity. The incidence of luminal A is
much greater than the incidence of the other two subtypes across every racial and ethnic
group. The incidence rate for triple negative breast cancer is at least 1.5 times greater for Black
women than for women of other race/ethnicities. Rates for the luminal B subtype do not vary
substantially across Minnesota’s racial and ethnic populations.
Table 1. Breast cancer subtypes in Minnesota, 2013-2017
Subtype Count Percent
Incidence
Rate/100,000
Luminal A (HR+, HER2-) 15,243 76% 92.8
Triple Negative (HR-, HER2-) 1,939 10% 12.4
Luminal B (HR+, HER2+) 2,169 11% 14.1
HER2-enriched (HR-, HER2+) 818 4% 5.2
Subtype unknown 1,399 NA NA
Source: Minnesota Cancer Reporting System (2013-2017 Minnesota breast cancer incidence rates). Rates are per 100,000
population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130). Percentages do not
include breast cancers with unknown subtypes (N=1,399). NA indicates percentages not calculated.
BREAST CANCER IN MINNESOTA WOMEN
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Figure 7. Luminal A (HR+, HER2-), Triple Negative (HR-, HER2-), and Luminal B
(HR+, HER2+) incidence rates by race/ethnicity, 2013-2017
50.6
67.7
67.6
95.4
63.8
8.3
10.9
11.0
12.2
17.2
10.0
14.1
12.9
14.4
13.4
Asian/Pacific Islander
American Indian/Alaska Native
Hispanic - All Races
White
Black
Luminal A Triple Negative Luminal B
Source: Minnesota Cancer Reporting System (2013-2017 incidence rates for subtypes by race/ethnicity). Incidence rates are per
100,000 population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
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Surviving breast cancer
The 5-year relative survival for women in Minnesota is high, nearly 93 percent. Relative survival
estimates the chance that women diagnosed with breast cancer survive at least five years
compared to women who do not have breast cancer. As in the U.S. overall, relative survival for
Minnesota women decreases as breast cancer spreads in the body, reaching a low point when
the disease has spread to distant sites away from the breast (Figure 8, Appendix Table A6). Five-
year relative survival is lower for Black women than it is for White women (Figure 9, Appendix
Table A7).
Survival also varies by molecular subtype. Women with the most common type of breast cancer
(luminal A) have a greater chance of surviving at least five years after diagnosis compared to
women with the triple negative subtype (Figure 10, Appendix Table A8).
Figure 8. Five-year relative survival (percent) is highest when diagnosed early
99.1
86.4
32.4
Localized
Regional
Distant
Source: Minnesota Cancer Reporting System, 2010-2017 with vital status follow-up in 2017. Age standardized to the International
Cancer Survival Standard 1 – Ages 15+.
BREAST CANCER IN MINNESOTA WOMEN
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Figure 9. Breast cancer relative survival (percent) by race/ethnicity
78.7%
87.0%
88.9%
92.9%
AIAN*
Black
API
Hispanic - All Races
White, Non-Hispanic
60% 70% 80% 90% 100%
Source: Minnesota Cancer Reporting System, 2010-2016 with vital status follow-up in 2017. Age standardized to the International
Cancer Survival Standard 1 – Ages 15+. AIAN* indicates that relative survival could not be estimated for American Indian/Alaska
Native women based on data available for this analysis. Grey bars represent 95 percent confidence intervals.
Figure 10. Triple negative breast cancers have the lowest relative survival
95.1%
90.3%
83.4%
79.5%
Luminal A, HR+, HER2-
Luminal B, HR+, HER2+
HER2-enriched, HR-, HER2+
Triple negative, HR-, HER2-
Source: Minnesota Cancer Reporting System, 2010-2016 with vital status follow-up in 2017. Age standardized to the International
Cancer Survival Standard 1 – Ages 15+.
BREAST CANCER IN MINNESOTA WOMEN
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Regional variations in Minnesota
The long-term annual average trends in incidence and mortality rates for both the Twin Cities 7-
County Metro and non-Metro regions of the state are similar to the trends for Minnesota
between 1988 and 2017. During this period, breast cancer incidence per 100,000 women was
consistently higher in the 7-County Twin Cities Metro compared to the non-Metro region
(Figure 11, Appendix Table A9). Mortality rates for both regions over the past 30 years are
similar but rates for the non-Metro show more variability (Figure 12, Appendix Table A9).
There are long-standing differences in population demographics, and availability and access to
health care systems between the Metropolitan and non-Metropolitan regions of the state [16].
Compared to the Metropolitan areas, residents of the non-Metropolitan areas are older on
average, have longer distances to travel for health care, and face barriers to receiving care from
medical specialists, who are concentrated in the Metropolitan areas of the state. As such, state
and local cancer prevention and control efforts need to take into account these and other
challenges non-Metropolitan area residents experience in seeking health care services.
Figure 11. Breast cancer incidence rates have been historically lower in the non-
Metro than in the Twin Cities 7-County Metro
0
40
80
120
160
1985 1990 1995 2000 2005 2010 2015 2020
7-County Metro Non-Metro
Source: Minnesota Cancer Reporting System 1988-2017 (Minnesota breast cancer age-standardized incidence rates). Rates are
per 100,000 population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
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Figure 12. Breast cancer mortality rates have been decreasing in Twin Cities 7-
County Metro and non-Metro regions since 1988
0
10
20
30
40
1985 1990 1995 2000 2005 2010 2015 2020
7-County Metro Non-Metro
Source: Minnesota Department of Health Office of Vital Records (1988-2017 Minnesota age-standardized mortality rates). Rates
are per 100,000 population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
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Risk and protective factors
A variety of factors affect a woman’s risk of developing breast cancer. Risk factors increase the
risk of breast cancer while protective factors decrease the risk of this cancer. Some factors are
internal to a person like age or genetics, while other factors are external to a person, like
exposure to radiation or alcohol consumption.
Women have control over some risk and protective factors and this offers women opportunities
to try to reduce their risk of developing breast cancer. Maintaining a heathy weight, minimizing
alcohol consumption, and being physically active are protective factors that can lower a
woman’s risk of some breast cancers. However, breast cancer is not completely understood.
Some women diagnosed with breast cancer do not have any known risk factors for the disease.
Few cancers have a single cause. Instead there are multiple risk and protective factors that
interact over time to cause cells to grow abnormally [17]. Emerging research suggests that the
effect of known risk factors on breast cancer risk is different by subtype [18]. Research is
ongoing to better understand the causes of breast cancer.
Age is one of the strongest risk factors for breast cancer. The risk of developing breast
cancer increases with age.
Certain genetic alterations and a family history of breast cancer increase the risk of breast
cancer.
Lifetime exposure to estrogen increases the risk of breast cancer. A woman’s lifetime
estrogen level is largely determined by her reproductive and menstrual history, and long-
term use of menopausal hormone replacement therapy.
Certain exposures including chest radiation therapy for a previous cancer and the use of
diethylsilbesterol (DES) during pregnancy increase risk.
Individual factors that increase a woman’s risk of breast cancer include a personal history of
breast cancer and breast density.
Modifiable lifestyle factors that increase risk include increased body weight, lack of physical
activity, and alcohol consumption.
Screening for breast cancer
The goal of screening for breast cancer is to detect the disease before symptoms develop and
treat it early, when cancers respond better to treatment. Screening guideline recommendations
depend on age, family history and individual risk [19]. Women should talk with their health care
providers about breast cancer screening tests and when to have them.
Women who do not have health insurance, or have insurance that does not fully cover breast
cancer screening costs, may be eligible to receive free screening in Minnesota through MDH’s
Sage Program [20] or the American Indian Cancer Foundation’s Screen Our Circle Program [21].
Women screened through the Sage or Screen Our Circle programs who need follow-up
treatment may qualify for Medical Assistance for Breast or Cervical Cancer (MA-BC) [22]. This
program covers treatment and other MA-covered service costs until treatment ends.
BREAST CANCER IN MINNESOTA WOMEN
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22. Minnesota Department of Human Services. Medical Assistance for Breast or Cervical
Cancer (MA-BC). Available from: https://mn.gov/dhs/people-we-serve/adults/health-
care/health-care-programs/programs-and-services/breast-cervical-cancer.jsp.
BREAST CANCER IN MINNESOTA WOMEN
19
Data sources and methods
Data sources
Minnesota cancer incidence data
Cancer incidence data for this report were drawn from the MCRS database on January 2020.
The database contains information on nearly all microscopically confirmed malignant and in situ
cancers diagnosed in Minnesota residents between 1988 and 2017. After a rule change, both
clinical and microscopically confirmed cancers were reported to the state’s cancer registry,
starting in 2012. Cancers excluded from reporting include the most common forms of skin
cancer (basal and squamous cell carcinomas) and in situ carcinomas of the cervix. These
exclusions are consistent with guidelines for cancer registration practice in the U.S. (See
Registry Methods and Standards below.) For detailed information about cancer reporting in
Minnesota, cancer statistics and reports, legislative authority, and archived reports and
publications, please visit Minnesota Cancer Reporting System
(https://www.health.state.mn.us/data/mcrs/index.html).
Minnesota cancer mortality data
Gathering data on Minnesotans with cancer from death certificates is necessary to completely
describe the cancer burden, as well as to evaluate the progress made in treating and controlling
cancer in Minnesota. Mortality data are obtained from electronic death certificates on
Minnesota residents. Only the underlying cause of death is used in calculating cancer mortality
rates. To learn more about the Office of Vital Records and death certificates, in particular,
please visit Minnesota Center for Health Statistics, Office of Vital Records
(https://www.health.state.mn.us/people/vitalrecords/about.html).
Surveillance, Epidemiology, and End Results (SEER) 9 Registries
Data from the SEER 9 Program registries provides data for long-term trend analyses covering
approximately 9.4% of the U.S. population residing in San Francisco-Oakland, Connecticut,
Metropolitan Detroit, Hawaii, Iowa, New Mexico, Seattle (Puget Sound), Utah, Metropolitan
Atlanta. For more information see SEER*Stat Databases: November 2019 submission
(https://seer.cancer.gov/data-software/documentation/seerstat/nov2019/)
U.S. Mortality Data
The National Center for Health Statistics (NCHS) collects and maintains U.S. mortality data. For
more information on the data used in this report, go to U.S. Mortality Data, 1969-2018
(https://seer.cancer.gov/mortality/)
Population data
The NCI’s website contains population data used in generating statistics for this report. The U.S.
Census Bureau develops annual population estimates. Census population estimation methods
and the population estimates used in the calculations. See the National Cancer Institute (NCI) –
U.S. Population Data – 1969-2017 (https://seer.cancer.gov/popdata/) page for more
information.
BREAST CANCER IN MINNESOTA WOMEN
20
Methods for data analyses
Analytic software
Incidence and mortality counts and age-adjusted rates for this report were generated using
NCI’s SEER*Stat software. Trend statistics and average annual percent change estimates were
generated using NCI’s Joinpoint software.
Defining cancer statistics
For more information about statistics used to assess the impact of cancer in the general
population, go to NCI Defining Cancer Statistics page
(https://seer.cancer.gov/statistics/types.html).
Age-adjusted rate
To learn what an age-adjusted rate is and how it is calculated, please see the NCI Tutorial to
Calculate Age-Adjusted Rates
(https://seer.cancer.gov/seerstat/tutorials/aarates/definition.html).
Unstable rate
An unstable rate is defined as one with a cancer count less than 20, or a relative standard error
(100 x SE/Rate) > 30%. If a rate was unstable only counts were included in a table. Unstable
rates in the tables are denoted with NA.
Standard population
To learn more about the 2000 U.S. standard population used in calculating age-adjusted rates,
go to NCI-2000 US Standard Population
(https://seer.cancer.gov/stdpopulations/single_age.html).
Minnesota geographic divisions
Metropolitan areas of the state were defined as the Twin Cities 7-County Metropolitan area
including the counties of Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington. In
2015, this area exceeded 3 million residents. The non-Metro area include the other 80
Minnesota counties.
Collecting and processing cancer incidence and mortality data
MCRS authority and data protection
For information on the history, statutory authority, and objectives of the Minnesota
Department of Health’s statewide cancer registry please visit Legislative Authority for MCRS
(https://www.health.state.mn.us/communities/practice/schsac/index.html).
For information on the Minnesota Government Data Practices Act please visit Minnesota
Government Data Privacy Act
(https://www.health.state.mn.us/communities/practice/resources/chsadmin/data-
mgdpa.html).
BREAST CANCER IN MINNESOTA WOMEN
21
Registry methods and standards
The North American Association of Central Cancer Registries (NAACCR) provides the data
dictionary and standards governing data collection, coding, and processing used in member
central cancer registries to develop high quality cancer data needed to address the cancer
burden in North America, including Minnesota. For more information about NAACCR please
visit the section “Central Registry Standards” on the North American Association of Central
Cancer Registries (NAACCR) (https://www.naaccr.org/) page.
Glossary of terms
To look up unfamiliar terms please visit NCI Glossary of Statistical Terms
(https://seer.cancer.gov/cgi-bin/glossary/glossary.pl) page.
Cancer prevention resources
Comprehensive Cancer Control Program
The Comprehensive Cancer Control Program
(https://www.health.state.mn.us/diseases/cancer/compcancer/index.html) at the Minnesota
Department of Health is a CDC funded initiative to strengthen efforts across Minnesota to
decrease the impacts of cancer. To achieve this objective, program staff collaborated with the
Minnesota Cancer Alliance (below) to develop the Cancer Plan Minnesota 2025: A Framework
for Action. (https://mncanceralliance.org/cancer-plan/.
Minnesota Cancer Alliance
The Minnesota Cancer Alliance is a coalition of more than 100 organizations from diverse
backgrounds and disciplines dedicated toward reducing the burden of cancer in Minnesota.
Members are actively working to achieve the objectives of the Cancer Plan Minnesota 2025. For
more information, go to Minnesota Cancer Alliance (https://mncanceralliance.org/).
Sage Screening Programs
The Minnesota Department of Health’s Sage Screening Programs provide free screening for
breast and cervical cancer at participating locations across Minnesota. The program has a wide
network of partners working together to reduce the burden of cancer by providing access to
and promoting breast and cervical cancer screening services for Minnesota’s uninsured and
underinsured populations. For more information, go to MDH Sage Screening Programs
(https://www.health.state.mn.us/diseases/cancer/sage/about/index.html/).
Healthy Minnesota Partnership
The Healthy Minnesota Partnership is a collaboration between community partners and the
Minnesota Department of Health to improve the health and quality of life for individuals,
families and communities in the state. The Healthy Minnesota 2020 Framework identifies and
acts on strategic opportunities to improve health and well-being for all people in Minnesota.
The most recent progress report was produced as a collaboration between the Minnesota
Department of Health and the Healthy Minnesota Partnership. To access the report, go to
BREAST CANCER IN MINNESOTA WOMEN
22
Healthy Minnesota 2020 Update
(https://www.health.state.mn.us/communities/practice/healthymnpartnership/docs/annualre
port2017.pdf/).
Center for Health Equity
The Center for Health Equity (CHE) was created in 2013 to advance health equity as a practice
or approach within the Minnesota Department of Health and across the state. Under CHE’s
leadership, Minnesota’s approach addresses health disparities as part of a broad spectrum of
public investments in housing, transportation, education, economic opportunity and criminal
justice. CHE also carries out specific initiatives and projects, including state funding available to
Tribal Nations to support Eliminating Health Disparities Initiative (EHDI) activities (Minnesota
Statute 145.928, subdivision 10). EHDI funding is for various activities in health areas including
decreasing morbidity and mortality rates from breast and cervical cancer, diabetes, HIV/AIDS
and other health conditions. For more information, go to MDH Center for Health Equity
(https://www.health.state.mn.us/communities/equity/about/index.html/).
Statewide Health Improvement Partnership
SHIP works to create healthier communities across Minnesota by expanding opportunities for
active living, healthy eating and tobacco-free living. At its core, SHIP is a locally driven effort,
with community partnerships formed to create better health together across Minnesota.
Communities choose strategies that are based on the latest science and focused on making
long-term, sustainable changes in schools and child care facilities, communities, workplaces and
health care settings. SHIP has been instrumental in helping Minnesota keep obesity rates
relatively flat, and reducing commercial tobacco use and secondhand smoke exposure. These
factors contribute to chronic diseases, rising health care costs, disability and death. For more
information about SHIP, go to Statewide Health Improvement Partnership
(https://www.health.state.mn.us/communities/ship/).
BREAST CANCER IN MINNESOTA WOMEN
23
Appendix
Table A1. 30-year breast cancer incidence and mortality rate (per
100,000) trend data, 1988-2017
Year
Minnesota
Incidence
Rate
Minnesota
incidence
Count
SEER 9
incidence
Rate
SEER 9
Incidence
Count
Minnesota
Mortality
Rate
Minnesota
Mortality
Count
U.S.
Mortality
Rate
U.S.
Mortality
Count
1988 132.3 2,854 131.4 14,902 33.9 765 33.2 42,169
1989 127.1 2,768 127.3 14,645 31.9 716 33.2 42,836
1990 132.3 2,905 131.9 15,410 32.5 746 33.1 43,389
1991 130.7 2,921 133.9 15,905 33.5 786 32.7 43,582
1992 130.6 2,947 132.1 16,043 30.3 726 31.6 43,063
1993 131.1 3,017 129.2 15,977 29.9 732 31.4 43,554
1994 126.9 2,973 131.0 16,444 28.7 708 30.9 43,644
1995 133.9 3,170 132.8 16,977 30.9 773 30.6 43,843
1996 130.6 3,155 133.8 17,360 28.3 725 29.5 43,090
1997 132.3 3,240 138.1 18,282 26.0 678 28.2 41,943
1998 140.6 3,510 141.5 19,062 26.8 720 27.5 41,736
1999 138.9 3,499 141.6 19,352 24.8 669 26.6 41,144
2000 142.8 3,662 136.7 18,975 26.7 729 26.6 41,872
2001 139.8 3,646 138.9 19,589 24.7 685 26.0 41,394
2002 135.6 3,608 135.9 19,461 22.5 640 25.6 41,514
2003 126.0 3,403 127.1 18,488 22.7 639 25.3 41,619
2004 122.9 3,379 128.4 18,962 22.4 655 24.5 40,954
2005 124.6 3,486 126.8 19,048 22.3 656 24.1 41,116
2006 124.5 3,537 126.5 19,370 20.4 609 23.6 40,820
2007 131.9 3,809 128.5 19,979 20.6 636 23.0 40,598
2008 128.9 3,790 128.6 20,329 21.4 673 22.6 40,589
2009 131.7 3,943 131.0 21,137 21.2 684 22.2 40,676
2010 128.5 3,865 127.3 20,878 19.9 648 21.9 40,996
2011 135.4 4,140 130.6 21,773 19.4 637 21.6 40,931
2012 130.3 4,077 130.4 22,191 17.8 605 21.3 41,150
2013 128.1 4,022 131.2 22,596 19.5 665 20.8 40,860
2014 131.3 4,223 131.6 23,094 16.8 588 20.6 41,211
2015 135.1 4,377 131.8 23,550 19.4 686 20.3 41,523
BREAST CANCER IN MINNESOTA WOMEN
24
Year
Minnesota
Incidence
Rate
Minnesota
incidence
Count
SEER 9
incidence
Rate
SEER 9
Incidence
Count
Minnesota
Mortality
Rate
Minnesota
Mortality
Count
U.S.
Mortality
Rate
U.S.
Mortality
Count
2016 129.5 4,303 130.7 23,729 17.5 615 20.1 41,487
2017 138.4 4,643 131.6 24,236 17.0 627 19.9 42,000
Source: Minnesota Cancer Reporting System 1988-2017 (Minnesota breast cancer age-standardized incidence rates). Surveillance,
Epidemiology and End Results, 1988-2017 SEER 9 registries (age-standardized breast cancer incidence rates for Connecticut,
Detroit, Atlanta, San Francisco-Oakland, Hawaii, Iowa, New Mexico, Seattle-Puget Sound, Utah). Minnesota Department of Health
Office of Vital Records (1988-2017 Minnesota age-standardized mortality rates). National Center for Health Statistics (1988-2017
U.S. age-standardized mortality rates). Rates are per 100,000 population and age-standardized to the 2000 U.S. Standard
Population (19 age groups – Census P25-1130).
Table A2. Minnesota breast cancer incidence and mortality rates (per
100,000) by 5-year age-groups, 2013-2017
Year
Incidence
Rate
Incidence
Count
Mortality
Rate
Mortality
Count
0-4 0 0 0 0
5-9 0 0 0 0
10-14 0 0 0 0
15-19 0.1 1 0 0
20-24 1.6 14 0 0
25-29 10.6 95 0.6 5
30-24 31.5 297 2.3 22
35-39 64.2 551 3.6 31
40-44 128.6 1,039 8.7 70
45-49 203.8 1,775 15.7 137
50-54 236.3 2,313 21.0 206
55-59 261.6 2,560 27.6 270
60-64 351.2 2,975 39.8 337
65-69 438.9 2,977 55.7 378
70-74 524.9 2,594 70.4 348
75-79 489.3 1,809 88.4 327
80-84 437.8 1,260 117.4 338
85+ 337.9 1,308 184.0 712
Source: Minnesota Cancer Reporting System 2013-2017 (age-specific incidence rates). Minnesota Department of Health Office of
Vital Records (2013-2017 Minnesota age-specific mortality rates).
BREAST CANCER IN MINNESOTA WOMEN
25
Table A3. Minnesota breast cancer incidence and mortality rates (per
100,000) by race/ethnicity, 2013-2017
Race/Ethnicity Incidence Rate Incidence Count Mortality Rate Mortality Count
White, Non-Hispanic 135.1 19,928 18.2 2,978
Black 106.8 619 19.7 100
American Indian/Alaska Native 102.5 158 20.7 27
Asian/Pacific Islander 78.2 410 10.7 50
Hispanic - All Races 101.8 355 11.5 32
All Races 132.5 21,568 18.0 3,181
Healthy People 2020 breast cancer mortality target:
20.7 deaths/100,000 women
Source: Minnesota Cancer Reporting System 2013-2017 (age-standardized incidence rates). Minnesota Department of Health
Office of Vital Records (2013-2017 Minnesota age-standardized mortality rates). Rates are per 100,000 population and age-
standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
Table A4. Minnesota breast cancer incidence rates (per 100,000) by
stage at diagnosis and race/ethnicity, 2013-2017
Race/ethnicity Stage
Incidence
Rate
Count
American Indian/Alaska
Native
Early 63.3 97
American Indian/Alaska
Native
Late 37.3 59
Asian/Pacific Islander Early 50.0 258
Asian/Pacific Islander Late 28.0 151
Black Early 59.0 338
Black Late 46.1 274
Hispanic – All Races Early 64.0 211
Hispanic – All Races Late 34.4 137
White, Non-Hispanic Early 89.6 13,420
White, Non-Hispanic Late 42.4 5,981
All Races Combined Early 87.3 14,367
All Races Combined Late 42.0 6,619
Healthy People 2020 female late stage breast cancer target:
42.4 new cancers/100,000
Source: Minnesota Cancer Reporting System 2013-2017 (age-standardized incidence rates). Rates are per 100,000 population and
age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
BREAST CANCER IN MINNESOTA WOMEN
26
Table A5. Minnesota breast cancer incidence rates (per 100,000) by
race/ethnicity, 2013-2017
Race/Ethnicity Luminal A Rate Triple Negative Rate Luminal B Rate
White, Non-Hispanic 95.4 12.2 14.4
Black 63.8 17.2 13.4
American Indian/Alaska
Native
67.7 10.9 14.1
Asian/Pacific Islander 50.6 8.3 10.0
Hispanic - All Races 67.6 11.0 12.9
Source: Minnesota Cancer Reporting System 2013-2017 (age-standardized incidence rates). Rates are per 100,000 population and
age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
Table A6. Minnesota five-year relative breast cancer survival (percent)
by stage at diagnosis, 2010-2016
Stage at Diagnosis Count
Relative
Survival
Percent
Lower 95%
Confidence
Interval
Upper 95%
Confidence
Interval
Localized 18,577 99.1% 98.0% 99.6%
Regional 7,812 86.4% 84.9% 88.0%
Distant 1,370 32.4% 29.2%, 36.1%
Unstaged/Unknown 397 76.7% 68.6% 82.9%
Source: Minnesota Cancer Reporting System, 2010-2016 with vital status follow-up in 2017. Age standardized to the International
Cancer Survival Standard 1 – Ages 15.
Table A7. Minnesota five-year relative breast cancer survival (percent)
by race/ethnicity, 2010-2016
Race/ethnicity Count
Relative Survival
Percent
Lower 95%
Confidence
Interval
Upper 95%
Confidence
Interval
White, Non-Hispanic 25,816 92.9% 92.2% 93.6%
Black 737 78.7% 69.2% 85.6%
American Indian/Alaska
Native
218 NA NA NA
Asian/Pacific Islander 461 87.0% 78.4% 92.4%
Hispanic - All Races 454 88.9% 78.1% 94.6%
All Races 27,822 92.7% 92.0% 93.4%
Source: Minnesota Cancer Reporting System, 2010-2016 with vital status follow-up in 2017. Age standardized to the International
Cancer Survival Standard 1 – Ages 15+. NA indicates that relative survival could not be estimated for American Indian/Alaska
Native women based on data available for this analysis.
BREAST CANCER IN MINNESOTA WOMEN
27
Table A8. Minnesota five-year relative breast cancer survival (percent)
by subtype, 2010-2016
Subtype Relative survival
95% Lower
Confidence
Interval
95% Upper
Confidence
Interval
Luminal A, HR+, HER2- 95.1% 94.3% 95.9%
Luminal B, HR+, HER2+ 90.3% 87.3% 92.6%
HER2-enriched, HR-, HER2+ 83.4% 78.4% 87.3%
Triple Negative, HR-, HER2- 75.9% 76.7% 82.0%
Unknown 84.0% 80.8% 86.70%
Source: Minnesota Cancer Reporting System, 2010-2016 with vital status follow-up in 2017. Age standardized to the International
Cancer Survival Standard 1 – Ages 15+.
Table A9: Minnesota breast cancer incidence and mortality rate (per
100,000) trend data – Twin Cities 7-County Metropolitan and non-
Metropolitan counties, 1988-2017
Year
Metro
Incidence
Rate
Metro
Incidence
Count
Non-Metro
Incidence
Rate
Non-Metro
Incidence
Count
Metro
Mortality
Rate
Metro
Mortality
Count
Non-Metro
Mortality
Rate
Non-Metro
Mortality
Count
1988 131.1 1,320 134.5 1,534 36.0 370 32.1 395
1989 127.3 1,293 126.3 1,475 31.2 323 33.1 393
1990 137.7 1,426 127.2 1,479 33.0 348 32.2 398
1991 134.3 1,421 126.3 1,500 32.5 351 34.9 435
1992 138.9 1,497 122.9 1,450 32.7 362 28.1 364
1993 133.9 1,472 128.9 1,545 29.9 334 29.9 398
1994 131.7 1,489 122.2 1,484 28.5 328 29.1 380
1995 138.7 1,591 129.1 1,579 33.4 390 28.1 383
1996 136.1 1,596 124.4 1,559 29.0 348 27.8 377
1997 141.9 1,690 122.6 1,550 27.0 330 25.3 348
1998 143.6 1,755 137.3 1,755 27.4 344 26.3 376
1999 153.1 1,892 123.7 1,607 27.0 342 23.0 327
2000 150.1 1,900 135.4 1,762 28.2 368 25.3 361
2001 147.8 1,900 132.4 1,746 26.1 338 23.6 347
2002 141.5 1,863 129.3 1,745 22.8 309 22.3 331
2003 130.8 1,776 119.4 1,627 22.5 304 22.6 335
2004 122.2 1,682 122.2 1,697 23.4 323 21.4 332
BREAST CANCER IN MINNESOTA WOMEN
28
Year
Metro
Incidence
Rate
Metro
Incidence
Count
Non-Metro
Incidence
Rate
Non-Metro
Incidence
Count
Metro
Mortality
Rate
Metro
Mortality
Count
Non-Metro
Mortality
Rate
Non-Metro
Mortality
Count
2005 130.0 1,813 118.6 1,673 22.2 313 22.5 343
2006 126.5 1,806 121.7 1,731 22.0 316 18.8 293
2007 139.0 2,008 125.5 1,801 22.3 324 19.0 312
2008 135.1 2,013 122.8 1,777 21.4 326 21.2 347
2009 139.2 2,123 124.1 1,820 20.8 320 21.3 364
2010 134.0 2,051 122.5 1,814 20.9 326 18.9 322
2011 139.5 2,181 131.3 1,959 19.7 320 19.2 317
2012 132.4 2,131 126.9 1,946 16.4 273 19.2 332
2013 133.4 2,174 122.5 1,848 18.8 320 20.4 345
2014 134.1 2,260 127.9 1,963 17.8 310 15.6 277
2015 138.5 2,354 130.9 2,023 20.5 367 18.5 319
2016 134.2 2,333 124.2 1,970 17.1 300 17.7 312
2017 142.7 2,531 133.7 2,112 16.9 312 16.9 313
Source: Minnesota Cancer Reporting System 1988-2017 (Minnesota breast cancer age-standardized incidence rates). Minnesota
Department of Health Office of Vital Records (1988-2017 Minnesota age-standardized mortality rates). Rates are per 100,000
population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
29
Table A10. Minnesota state and county-level female breast cancer for incidence, mortality, and prevalence,
2013-2017
Region
Average
Annual
Cancers
5-year
Incidence
Rate
Incidence
Rate
Unstable
(Yes or
blank)
Late Stage
Incidence
Rate
Late Stage
Incidence
Rate
Unstable
(Yes or
blank)
Incident
Percent
Late Stage
Average
annual
deaths
5-year
Mortality
Rate
Mortality
Rate
Unstable
(Yes or
blank)
Cancer
Prevalence
Cancer
Prevalence
Percent
Minnesota 4314 132.5 Blank 42.0 Blank 32 635 18.0 Blank 61650 2.2
Aitkin 16 109.6 Blank 32.2 Yes 23 2 13.5 Yes 240 3.0
Anoka 261 130.8 Blank 45.2 Blank 35 35 18.0 Blank 3610 2.0
Becker 29 124.2 Blank 37.8 Blank 29 3 12.1 Yes 430 2.5
Beltrami 35 138.6 Blank 51.3 Blank 35 6 21.6 Blank 550 2.3
Benton 24 113.5 Blank 40.9 Blank 35 6 24.1 Blank 340 1.7
Big Stone 4 106.1 Blank 15.7 Yes 22 2 22.7 Yes 50 2.0
Blue Earth 42 130.3 Blank 44.8 Blank 35 6 16.7 Blank 650 1.9
Brown 27 147.4 Blank 53.1 Blank 32 4 19.9 Blank 370 2.8
Carlton 28 131.7 Blank 43.4 Blank 35 5 21.5 Blank 440 2.5
Carver 74 143.0 Blank 42.9 Blank 30 9 17.1 Blank 940 1.8
Cass 30 122.7 Blank 33.9 Blank 29 6 24.4 Blank 510 3.5
Chippewa 10 108.3 Blank 38.1 Yes 35 2 23.8 Yes 160 2.5
Chisago 44 135.9 Blank 48.7 Blank 36 5 16.3 Blank 600 2.2
Clay 40 126.4 Blank 36.2 Blank 28 5 13.0 Blank 560 1.7
Clearwater 5 94.4 Blank 25.7 Yes 26 2 20.5 Yes 60 1.4
Cook 7 171.2 Blank 43.8 Yes 22 2 34.6 Yes 110 4.0
Cottonwood 11 141.3 Blank 43.1 Yes 23 2 24.1 Yes 220 3.7
BREAST CANCER IN MINNESOTA WOMEN
30
Region
Average
Annual
Cancers
5-year
Incidence
Rate
Incidence
Rate
Unstable
(Yes or
blank)
Late Stage
Incidence
Rate
Late Stage
Incidence
Rate
Unstable
(Yes or
blank)
Incident
Percent
Late Stage
Average
annual
deaths
5-year
Mortality
Rate
Mortality
Rate
Unstable
(Yes or
blank)
Cancer
Prevalence
Cancer
Prevalence
Percent
Crow Wing 57 122.3 Blank 42.6 Blank 33 6 12.3 Blank 940 2.8
Dakota 341 141.2 Blank 45.4 Blank 32 41 17.1 Blank 4660 2.1
Dodge 13 106.6 Blank 30.2 Yes 29 3 20.7 Yes 160 1.5
Douglas 38 140.6 Blank 39.2 Blank 26 6 18.5 Blank 590 3.0
Faribault 12 119.4 Blank 34.8 Yes 35 2 14.2 Yes 180 2.5
Fillmore 16 109.9 Blank 42.8 Blank 37 2 9.0 Yes 220 2.0
Freeborn 29 125.5 Blank 32.2 Blank 38 5 19.3 Blank 450 2.8
Goodhue 41 135.8 Blank 32.2 Blank 30 7 17.9 Blank 620 2.6
Grant 5 125.9 Blank 68.4 Yes 46 1 35.7 Yes 90 3.0
Hennepin 947 137.4 Blank 42.6 Blank 31 138 18.8 Blank 13120 2.0
Houston 16 119.6 Blank 36.2 Blank 31 1 8.3 Yes 240 2.5
Hubbard 17 116.8 Blank 49.5 Blank 38 3 16.1 Yes 300 2.8
Isanti 32 142.2 Blank 53.0 Blank 37 6 23.2 Blank 450 2.3
Itasca 44 129.5 Blank 31.3 Blank 22 6 14.7 Blank 620 2.7
Jackson 10 141.1 Blank 63.7 Yes 41 2 21.8 Yes 160 3.1
Kanabec 18 149.4 Blank 57.0 Blank 40 2 14.1 Yes 260 3.2
Kandiyohi 40 149.0 Blank 52.8 Blank 33 8 26.5 Blank 630 2.9
Kittson 5 128.5 Blank 47.1 Yes 41 1 35.8 Yes 60 2.7
Koochiching 9 94.6 Blank 25.7 Yes 28 3 23.9 Yes 150 2.3
Lac qui Parle 6 139.8 Blank 89.3 Yes 59 2 23.3 Yes 100 2.8
BREAST CANCER IN MINNESOTA WOMEN
31
Region
Average
Annual
Cancers
5-year
Incidence
Rate
Incidence
Rate
Unstable
(Yes or
blank)
Late Stage
Incidence
Rate
Late Stage
Incidence
Rate
Unstable
(Yes or
blank)
Incident
Percent
Late Stage
Average
annual
deaths
5-year
Mortality
Rate
Mortality
Rate
Unstable
(Yes or
blank)
Cancer
Prevalence
Cancer
Prevalence
Percent
Lake 11 126.1 Blank 46.9 Yes 33 2 21.8 Yes 150 2.9
Lake of the Woods 4 137.1 Yes 51.0 Yes 42 1 38.2 Yes 60 3.3
Le Sueur 24 139.5 Blank 41.4 Blank 30 2 10.7 Yes 340 2.4
Lincoln 6 135.7 Blank 48.4 Yes 32 1 24.6 Yes 100 3.3
Lyon 19 121.2 Blank 33.1 Blank 25 3 16.8 Yes 290 2.1
McLeod 26 112.1 Blank 44.2 Blank 38 5 21.7 Blank 420 2.3
Mahnomen 4 104.4 Yes 38.9 Yes 39 1 14.1 Yes 50 1.9
Marshall 9 137.7 Blank 33.2 Yes 18 1 11.6 Yes 130 2.6
Martin 20 142.5 Blank 42.9 Blank 31 4 20.7 Yes 300 2.8
Meeker 17 100.8 Blank 48.2 Blank 49 4 26.1 Blank 290 2.4
Mille Lacs 23 136.2 Blank 51.6 Blank 36 5 30.0 Blank 310 2.3
Morrison 24 113.9 Blank 35.0 Blank 31 3 11.5 Yes 360 2.1
Mower 32 124.2 Blank 27.0 Blank 30 5 15.5 Blank 460 2.2
Murray 9 142.8 Blank 45.8 Yes 34 2 23.1 Yes 130 2.9
Nicollet 29 151.8 Blank 36.7 Blank 24 2 8.6 Yes 400 2.3
Nobles 16 130.6 Blank 36.6 Blank 26 3 22.7 Yes 240 2.1
Norman 5 102.7 Blank 39.5 Yes 40 1 17.5 Yes 80 2.5
Olmsted 123 137.6 Blank 39.3 Blank 29 15 15.0 Blank 1740 2.1
Otter Tail 57 129.1 Blank 45.8 Blank 34 8 16.3 Blank 840 2.8
Pennington 7 88.1 Blank 29.9 Yes 30 2 17.5 Yes 110 1.5
BREAST CANCER IN MINNESOTA WOMEN
32
Region
Average
Annual
Cancers
5-year
Incidence
Rate
Incidence
Rate
Unstable
(Yes or
blank)
Late Stage
Incidence
Rate
Late Stage
Incidence
Rate
Unstable
(Yes or
blank)
Incident
Percent
Late Stage
Average
annual
deaths
5-year
Mortality
Rate
Mortality
Rate
Unstable
(Yes or
blank)
Cancer
Prevalence
Cancer
Prevalence
Percent
Pine 21 108.5 Blank 42.8 Blank 40 4 19.0 Blank 310 2.3
Pipestone 8 117.9 Blank 49.0 Yes 41 2 21.2 Yes 130 2.7
Polk 28 145.9 Blank 65.6 Blank 43 3 14.4 Yes 410 2.5
Pope 11 121.6 Blank 31.1 Yes 22 2 24.1 Yes 170 3.0
Ramsey 406 132.2 Blank 39.2 Blank 29 58 17.4 Blank 5820 2.0
Red Lake 4 132.4 Yes 22.5 Yes 24 0 14.9 Yes 60 2.8
Redwood 12 115.8 Blank 38.0 Yes 29 4 29.0 Yes 180 2.3
Renville 10 112.1 Blank 36.4 Yes 30 2 17.5 Yes 140 1.8
Rice 52 138.8 Blank 37.0 Blank 27 9 21.9 Blank 750 2.3
Rock 8 126.8 Blank 28.1 Yes 20 2 24.7 Yes 150 3.0
Roseau 12 131.8 Blank 51.0 Blank 36 2 22.5 Yes 190 2.4
St. Louis 147 111.9 Blank 37.7 Blank 32 23 15.2 Blank 2250 2.2
Scott 96 136.1 Blank 38.0 Blank 29 13 19.7 Blank 1280 1.7
Sherburne 58 126.0 Blank 37.2 Blank 31 9 19.2 Blank 770 1.7
Sibley 12 128.1 Blank 45.1 Blank 39 2 17.8 Yes 170 2.2
Stearns 108 128.0 Blank 40.9 Blank 31 14 16.3 Blank 1440 1.8
Steele 36 168.4 Blank 45.5 Blank 33 5 19.0 Blank 520 2.7
Stevens 6 127.7 Blank 43.9 Yes 31 1 10.2 Yes 110 2.1
Swift 8 98.9 Blank 26.4 Yes 21 1 20.6 Yes 140 2.8
Todd 19 113.5 Blank 34.8 Blank 29 2 10.1 Yes 280 2.3
BREAST CANCER IN MINNESOTA WOMEN
33
Region
Average
Annual
Cancers
5-year
Incidence
Rate
Incidence
Rate
Unstable
(Yes or
blank)
Late Stage
Incidence
Rate
Late Stage
Incidence
Rate
Unstable
(Yes or
blank)
Incident
Percent
Late Stage
Average
annual
deaths
5-year
Mortality
Rate
Mortality
Rate
Unstable
(Yes or
blank)
Cancer
Prevalence
Cancer
Prevalence
Percent
Traverse 6 230.0 Blank 142.7 Yes 54 1 22.8 Yes 60 3.6
Wabasha 23 145.2 Blank 44.6 Blank 31 3 14.2 Yes 340 3.1
Wadena 12 119.6 Blank 57.0 Blank 47 3 29.5 Yes 210 2.9
Waseca 14 105.5 Blank 35.6 Blank 38 3 24.5 Yes 230 2.3
Washington 206 140.4 Blank 45.5 Blank 32 29 19.1 Blank 2740 2.1
Watonwan 7 94.7 Blank 28.5 Yes 31 1 9.9 Yes 110 1.9
Wilkin 6 134.3 Blank 34.5 Yes 26 2 49.4 Yes 70 2.4
Winona 41 140.5 Blank 52.6 Blank 38 5 16.5 Blank 630 2.4
Wright 88 128.3 Blank 41.8 Blank 33 12 17.2 Blank 1180 1.8
Yellow Medicine 8 101.3 Blank 28.9 Yes 24 1 23.5 Yes 140 2.6
Source: Minnesota Cancer Reporting System 1988-2017 (Minnesota breast cancer age-standardized incidence rates). Minnesota Department of Health Office of Vital Records (1988-2017 Minnesota
age-standardized mortality rates). Rates are per 100,000 population and age-standardized to the 2000 U.S. Standard Population (19 age groups – Census P25-1130).
