Breast cancer deaths decline more slowly for some
NEW YORK (Reuters Health) - Since 1990, the overall breast cancer death rates in the United States have decreased by about 24 percent, researchers report in the Journal of Clinical Oncology.
While the rates have declined for women with estrogen receptor (ER)-positive or ER-negative tumors, lead investigator Dr. Ismail Jatoi told Reuters Health, the decrease has been greater for women with ER-positive tumors and younger women.
The growth of estrogen-receptor positive breast cancers is stimulated by body's own production of this hormone. Drugs such as tamoxifen work by blocking the effects of this estrogen on the breast tissue.
Jatoi of the National Naval Medical Center, Bethesda, Maryland and colleagues examined data contained in nine tumor registries that included almost 235,000 breast cancer cases diagnosed between 1990 and 2003.
During the study period, the risk of death in women younger than 70 years old with estrogen-receptor positive tumors fell by 38 percent, whereas the decline in women with estrogen-receptor negative tumors was just 19 percent.
In women older than 70 years, a 14-percent drop in death rates due to estrogen-receptor positive breast tumors was observed, but no there was no change in women with estrogen-receptor negative tumors.
"We speculate that these trends are at least partly due to mammography screening and the widespread use of tamoxifen in the 1990s," Jatoi commented.
"Although mortality in all groups remains unacceptably high," the investigators conclude, "additional emphasis should be placed on improving outcomes of breast cancer patients older than 70 years and those of all ages with estrogen-receptor negative tumors."
SOURCE: Journal of Clinical Oncology, May 1, 2007.
What breastcancer.org says about this article…
Breast cancer deaths decline more slowly for some
Improved breast cancer screening rates and advances in diagnosis and treatment are saving lives. The study reviewed here showed that between 1990 and 2003 breast cancer death rates dropped 24 percent. This is the same thing as survival rates increasing by 24%.
Many factors affect how aggressive breast cancer might be and how likely a woman is to survive after breast cancer. Breast cancers that are small and diagnosed early are generally easier to treat and cure. Because of better and more widespread screening, it's likely that detecting breast cancers earlier is responsible for a large part of the survival rate increase.Breast cancers that are hormone-receptor-positive tend to be less aggressive that those that are hormone-receptor-negative. Hormonal therapies such as tamoxifen and aromatase inhibitors are effectively used to treat and prevent the recurrence of hormone-receptor-positive breast cancers.
In this study, women with hormone-receptor-positive breast cancer had almost twice the increase in breast cancer survival rates than women with hormone-receptor-negative breast cancer. While great strides have been made in the treatment of hormone-receptor-negative breast cancer, these cancers tend to be more aggressive and less responsive to treatment.
It's a little surprising that women older than 70 had the smallest increase in breast cancer survival rates between 1990 and 2003. It's not clear why this happened. Unfortunately, it's possible that older women aren't offered all available treatment options. Research shows that breast cancer is often undertreated in older women.Increased survival rates are promising for all women, whether or not they have breast cancer.
- Regular screening makes a difference by detecting breast cancer earlier, when it's most treatable.
- Breast cancer treatment options are steadily improving for all types of breast cancer.
- Together with their doctors, women diagnosed with breast cancer can choose the best treatment options for them, regardless of age or breast cancer type.
