Breast Cancer Survival Rates Better, But Not for All
Breast cancer death rates continue to decline more than 2 percent annually, a long-running trend that can be traced to early detection and better treatments, according to a new American Cancer Society (ACS) report.
However, the death rates are not declining as quickly among African-American women as among Caucasian and Hispanic women.
In 2007, about 178,480 new cases of invasive breast cancer will be diagnosed in American women, and another 62,030 cases of localized breast cancer will be found.
About 40,460 women are expected to die from the disease this year, second only to lung cancer, the report says. The report is called Breast Cancer Facts & Figures 2007-2008.
Decrease in HRT Use, Screening Falls Off
The decline in overall reported breast cancer cases, starting in 2000, is believed to be related to two factors.
One is the decreased use of hormone replacement therapy (HRT), which has been linked to a multitude of health risks, including breast cancer.
The other factor could be potentially troubling, experts say: A decrease in mammography screening, resulting in fewer cancers being detected.
While 70 percent of women ages 40 and older said they had had a mammogram within the past two years in 2000, just 66 percent did in 2005.
Aside from skin cancer, breast cancer is the most frequently diagnosed cancer among US women, accounting for more than one in four malignancies detected in women.
From 1995-2004, the drop in breast cancer death rates was highest in Caucasians and Hispanics/Latinas, at 2.4 percent per year, but lower in African Americans, at 1.6 percent annually.
It remained unchanged among other racial and ethnic groups, including Asian-Americans/Pacific Islanders and American Indians/Alaska Natives.
Mammograms Still Best Bet
Breast cancer incidence rates have been declining sharply since 2001, by nearly 5 percent annually, in women ages 50 and older, partly due to the drop in use of hormone replacement therapy. Incidence rates in younger women, however, have remained stable since 1986.
Although breast cancer in men is rare, the incidence in males increased 1 percent a year between 1975 and 2004. The cause is not known.
"For women concerned about the risk of developing and dying from breast cancer, probably still the most important advice is to get regular mammograms as recommended by the ACS," says Elizabeth Ward, Ph.D., director of surveillance research for the ACS, and a contributor to the report.
Other preventive measures, says Dr. Ward: "If you have a family history, you should be talking about that history with your doctor. It may be recommended to begin screening sooner [than age 40].
Women should try to maintain a healthy weight all through their life. Women should consume no more than one alcoholic beverage a day. Exercise is also a good way to decrease risk. Physical activity has a small protective effect."
Dr. Eric P. Winer, director of the breast oncology center at the Dana-Farber Cancer Institute in Boston, and chief scientific advisor for Susan G. Komen for the Cure, says the new report contains "both good and bad news."
"It is clear that we have new diagnostic tools that have the potential to allow us to detect breast cancer at even earlier stages," says Dr. Winer. "Perhaps more importantly, we also have many new treatment strategies.
These treatments, particularly if properly applied, will save lives and reduce suffering," he says. "There has been, and continues to be, a decline in death from breast cancer."
Dr. Winer adds that the report contains some troubling news, including the divergence in breast cancer rates between Caucasian and African-American women. It is a trend, he said, that "almost certainly relates to access to care and access to the best possible care."
"In spite of our best efforts, a substantial minority of women continue to be diagnosed when the disease has advanced to stage IV and is no longer curable. Again, this is a small minority, but it still represents a significant number of women," he says.
"In some cases, the cause of this is that women did not have access to health care," says Dr. Winer. "In other cases, it is because breast cancer can, at times, be quite aggressive and simply cannot be caught before it has spread. To combat this problem, we need greater access to care for all Americans and we need better treatment approaches."
Always consult your physician for more information.
Online Resources
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Department of Defense - Breast Cancer Program
National Alliance of Breast Cancer Organizations
National Breast and Cervical Cancer Early Detection Program
National Breast Cancer Coalition
National Breast Cancer Foundation