October 1, 2010 — A steady improvement in survival from breast cancer over the past 6 decades has been shown in a review of records from the University of Texas M.D. Anderson Cancer Center in Houston.
The review shows a "dramatic shift in the natural history of the disease," said Aman Buzdar MD, professor of medicine and breast medical oncology at M.D. Anderson.
"If patients are appropriately managed, they have a much better chance of surviving breast cancer today than they would have had 20, 30, or even 10 years ago, because therapies are constantly evolving and improving," he added.
Dr. Buzdar was speaking last week at an American Society for Clinical Oncology presscast; the data were presented at the 2010 Breast Cancer Symposium, in Washington, DC, on October 2, 2010.
"This is an elegant review of patient records from a single institution that shows major improvements in breast cancer survival over recent years," said Jennifer Obel, MD, from the NorthShore University Health System in Evanston, Illinois, who was moderating the presscast.
Although these data come from a single institution, both Dr. Buzdar and Dr. Obel said that the improvements in survival should be generalizable to other institutions and to the community.
Review of Past 60 Years
Dr. Buzdar and colleagues examined records dating back to 1944 for nearly 57,000 breast cancer patients, of whom 12,809 had initial therapy at M.D. Anderson. Patients were divided into 3 general cancer stages — local, regional, and distant (with metastases) — and 10-year survival rates were calculated.
Improvements in survival were seen at each cancer stage, and in some cases the shift was dramatic, Dr. Buzdar noted.
For example, among women with regional breast cancer in 1944 to 1954, only 16.2% were still alive 10 years later, compared with 74% in the most recent decade (1995 to 2004) analyzed.
The improvements are due to a number of factors, Dr. Buzdar said, including earlier diagnosis and the combined modality approach to treatment, where systemic therapy is offered to women at high risk for recurrence, even though the initial presentation of the disease is local.
Ten-Year Survival Rates by Stage of Breast Cancer
| Decade | Local, % | Regional, % | Distant, % | Overall survival, % (n) |
| 1944–54 | 55 | 16 | 3 | 25 (410) |
| 1955–64 | 56 | 24 | 4 | 30 (1449) |
| 1965–74 | 59 | 29 | 5 | 35 (1387) |
| 1975–84 | 72 | 47 | 7 | 49 (1983) |
| 1985–94 | 79 | 57 | 11 | 62 (2927) |
| 1995–2004 | 86 | 74 | 22 | 77 (4653) |
These data show that only 1 in 4 women were still alive after 10 years in the 1950s, whereas 3 in 4 women in recent years were, said Dr. Obel. "Care of breast cancer patients has evolved at a rapid pace," she added.
This news about improvement in breast cancer survival was highlighted recently in the New York Post in an opinion piece on curing breast cancer, written by Elizabeth Whelan, ScD, MS, MPH, president of the American Council on Science and Health (ACSH).
"The bottom line is that oncologists now have methods of upping the odds of surviving breast cancer — and in the large majority of cases, they are actually able to cure the disease," she writes.
This October is the 25th year of it being a Breast Cancer Awareness Month, she notes, and "while we may march for the 'the' cure, a cure, in many cases, may be already be at hand."
Dr. Whelan identified 3 factors that "have brought us closer to using the term 'cure' for many breast cancers." One is early detection through mammography, another is improved treatment of stage I breast cancer, most often with a lumpectomy followed by radiation. The third factor, in her opinion, is the use of aromatase inhibitors to prevent breast cancer recurrence, which she describes as being "as revolutionary . . . as statins have been to cardiovascular disease or antibiotics to infections."
These "unprecedented breakthroughs . . . are far more real than most of the 'cancer' threats that grab headlines," Dr. Whelan writes. The ACSH makes a point of critiquing media stories about cancer risks — as well as other disease risks — from chemicals, the environment, and other causes. A case in point is a study that links air pollution to diabetes, which it highlights in the same ACSH dispatch daily newsletter as the good news on breast cancer survival.
The 2010 Breast Cancer Symposium is cosponsored by the American Society of Breast Disease, the American Society of Breast Surgeons, the American Society of Clinical Oncology, the American Society of Radiation Oncology, the National Consortium of Breast Centers, the Society of Surgical Oncology, and Susan G. Komen for the Cure.
2010 Breast Cancer Symposium: Abstract 172. Presented October 2, 2010.
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Cite this: Breast Cancer Survival Has Improved Steadily Over Past 6 Decades - Medscape - Oct 03, 2010.
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