they relate to their health care provider, how the provider relates to them).

Breast Cancer. Excluding skin cancers, breast cancer is the most common cancer among women. According to the National Cancer Institute, approximately one in eight women in the United States will develop breast cancer during her lifetime with most cases occurring after the age of 50 (NCI, 1997). There is some evidence that the prevalence of certain risk factors for breast cancer may be higher among lesbians. Some studies have suggested that lesbians have higher rates of alcohol consumption and being overweight and that they are less likely to have had children than are women in general. However, it is important to state that the appropriate epidemiological research has yet to be done to determine whether lesbians are at greater risk for breast cancer. Thus, the committee concludes. that insufficient data are now available to determine whether lesbians have a higher risk for breast cancer than women in general.

Whether or not lesbians are at higher risk of breast cancer than heterosexual women, there is a common perception in the lesbian community that they are. In a controlled clinical trial of breast cancer risk, when lifetime risk of breast cancer was calculated for a sample of lesbians and for a general sample of women, women in the general sample were found to have a 13% mean risk of breast cancer by age 80 whereas women in the lesbian sample were found to have an 11% mean risk (Bowen et al., 1997). Both groups of women, however, perceived their risk to be substantially higher, with lesbians believing that they had a 36% mean lifetime risk and women in the general sample believing they had a 50% mean lifetime risk of breast cancer (i.e., by age 80). When only women with a family history of breast cancer were included ha the sample, the perceived lifetime risk was nearly identical for lesbians and the general sample. From this and other studies it is apparent that women (both lesbian and heterosexual) tend to believe that their risk of breast cancer is much higher than it really is. These misperceptions of risk can have an impact on whether or not one gets a regular mammogram and on one's quality of life (e.g., fear of breast cancer causing increased stress).

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