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Breast-Cancer Death Rate Drops Almost 40 Percent, Saving 322,000 Lives, Study Says (washingtonpost.com)
Breast cancer death rates declined almost 40 percent between 1989 and 2015, averting 322,600 deaths, the American Cancer Society reported Tuesday. From a report: Breast cancer death rates increased by 0.4 percent per year from 1975 to 1989, according to the study. After that, mortality rates decreased rapidly, for a 39 percent drop overall through 2015. The report, the latest to document a long-term reduction in breast-cancer mortality, attributed the declines to both improvements in treatments and to early detection by mammography. Deanna Attai, a breast cancer surgeon at the University of California at Los Angeles who was not involved in the study, said the advances in treatment included much better chemotherapy regimens -- developed in the 1980s and refined ever since -- that are administered post-surgery to reduce the risk of recurrence. Other improvements have included tamoxifen, an anti-estrogen agent that was approved in the late 1970s; Herceptin, a drug used to treat tumors with a higher-than-normal level of a protein called HER2 and drugs called aromatase inhibitors.
If I read that correctly, this means that of all the cases reported now, the overall odds of death have dropped 40% compared to all the cases reported thirty years ago or so. That doesn't mean the odds of survival for a given diagnosis have improved 40%. One reason cited was the increased early detection through mammograms, so clearly some of the improvement is from shifting the average diagnosis to a less severe tumor. This raises the issue of tumors that are now detected which in the 70s would have gone unnoticed, and wouldn't have progressed, but are now detected and removed. (I'm not an expert, but I read on the Internet that this is an issue, so it must be true.) If you take that into account, it may pull down the overall percentage a tick.
In any case, it's clearly good news, but I've still lost a friend from breast cancer, but I'm hopeful that another will survive. I'm looking forward to what the next decade or two bring with better understanding of the genetic differences of specific cancers and vaccines or other drugs designed to target those differences.
Over the past 30 years, my wife has survived breast cancer 3 times. All three occurrences were classified as new primaries. The third time was HER2 positive, which meant chemo for a year. The first six rounds were classic chemo plus Herceptin, followed by another 8 rounds of Herceptin only. She has also been on tamoxifen for the last 5 years. The first two occurrences were early enough that the HER2 factor wasn't even discovered. Thankfully, it seems that neither of the first two were HER2 positive anyway, as both were not as aggressive as the third. The key in all three cases was early detection. I noticed a comment above about delaying fate. In a way this is true, in that she will be able in the future to die of something other than breast cancer. In the mean time, we get to enjoy retirement together. Modern medicine has kept us both alive, as I am around thanks to a triple bypass.