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It’s a diagnosis any woman dreads, but fortunately there’s
good news: Fewer women are dying of breast cancer. In fact, between 1989 and
2015, the breast cancer death rate declined by 40%, according to a report by
the American Cancer Society. Experts estimate approximately 322,000 women who
would otherwise have died during that time period survived, in large part due
to advances in breast cancer detection and treatment.
Thanks to breast cancer research, American women diagnosed
with breast cancer are living longer, healthier lives than previous generations
of women affected with this all-too-common disease.
The good news: Breast cancer treatment is improving.
The five-year relative survival rate for women with stage 0
or stage 1 breast cancer is now nearly 100%. For stage II breast cancer (cancer
confined to the breast or nearby lymph nodes), the five-year relative survival
rate is about 93%. Cancer that has spread into the lymph system or nearby
muscles has a five-year survival rate of 72%; metastatic breast cancer, 22%.
Contrast those numbers with survival rates in the late
1970s. According to a review by the American Cancer Society, the five-year
survival rate for women with stage II breast cancer was just 55 to 68% in the
‘70s. Metastatic cancer, or breast cancer that’s spread to other organs, had a
five-year survival rate of only 16 to 19%.
Increased use of mammograms to detect breast cancer is one
reason breast cancer survival rates have increased. More cancers are caught at
earlier, more treatable stages.
New cancer treatments have also made a difference. The drug
Herceptin (trastuzumab) was approved in the late 1990s; it’s used to treat
HER2-positive breast cancer and has increased survival rates for women with
stage I to III HER2-positive cancer by more than 30%.
Healthcare providers now prescribe 10 years of Nolvadex
(tamoxifen) to some women post-breast cancer treatment, after research showed
taking the medication for a decade decreases the risk of death by nearly 30%.
And a medication called Verzenio (abemaciclib) was approved in September 2017.
It has been demonstrated to increase survival in women with estrogen
receptor-positive, HER2-negative breast cancer that worsens after hormone therapy.
The bad news: Racial disparities persist.
Unfortunately, advances in the treatment and detection of
breast cancer seem to have done little to close the racial gap in breast cancer
death rates. In every state in America, black women are more likely to die of
breast cancer than white women. As recently as 2015, the breast cancer death
rate for black women was 39% higher than the rate for white women.
Experts say these disparities are the result of a multitude
of social and physiological factors. Some women lack access to healthcare or
the means to pay for it, which can affect their rates of survival. Similarly,
researchers have shown that racism acts as a persistent stressor, and can
contribute to poor health.
From a medical perspective, black women are twice as likely
to be diagnosed with triple-negative breast cancer, a type of cancer that’s
particularly challenging to treat. They are also less likely to have
hormone-receptor (HR) positive breast cancer, and therefore less likely to
benefit from effective treatments like Herceptin or Nolvadex.
Looking forward: Ongoing research provides hope.
Innovation is happening at a fast pace in the world of
cancer treatment. Immunotherapy medications, which stimulate the immune system
to attack cancer, are revolutionizing the treatment of some cancers, including
lung cancer and skin cancer. Researchers are now studying them in breast cancer—and
in combination with traditional breast cancer treatments. Researchers also are looking
at targeted therapies, which target specific gene changes in cancer. Already,
two PARP inhibitors (a type of targeted therapy) show promise in treating
BRCA-positive breast cancers, or breast cancers related to mutations of the
BRCA1 or BRCA2 gene.
Survival rates for breast cancer will likely continue to
climb. Your healthcare provider can provide you with the latest information
regarding breast cancer advances and answer any questions you have about breast
cancer detection and treatment.