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.
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.
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.
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Today's high-quality screening mammography is the most effective tool available to physicians in detecting breast cancer before lumps can be felt or symptoms of cancer appear.
Early detection of breast cancer not only helps provide a woman with more options, but also increases the possibility of a favorable prognosis.
You may want to ask your physician about the amount of radiation used during the procedure and the risks related to your particular situation.
It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of x-rays, so that you can inform your physician.
Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time.
Special care is taken to ensure that the lowest possible amount of radiation exposure occurs when you have a mammogram.
A woman should avoid using deodorant and lotions and wear two-piece clothing on the day of her mammogram.
A specially-trained radiological technologist, who will perform the x-ray, will ask the woman to undress and stand next to the x-ray machine.
Two flat surfaces, or plates, are lowered and compress each breast for a few seconds. This compression is necessary to produce the best pictures using the lowest amount of radiation possible.
Some women find the pressure of the plates on their breasts to be uncomfortable or even somewhat painful.
Timing your mammogram when your breasts are not tender is important. In premenopausal women, this is usually one week after your menstrual period.
If you do experience discomfort or pain, remember that each x-ray takes just a few moments and could save your life.
Medicare covers mammography screening for women 65 and older every year.
Most states now require that health insurance policies offer mammography screening reimbursement. In addition, many mammography facilities also offer special programs and lower fees during National Breast Cancer Awareness Month in October.
For low income women, mammograms are covered through the National Breast and Cervical Cancer Early Detection Program. For more information, contact your state Department of Health.
Always consult your physician for more information.
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