Michael Hunter, MD on Medika Life

A Triumph of Science: Breast Cancer Survival

BREAST CANCER REMAINS A GLOBAL PROBLEM, impacting over 2.3 million people yearly. Today, we examine breast cancer survival improvements, a triumph of science. We’ll also look at strategies to reduce breast cancer risk.

The World Health Organization offers that in 2020, there were 2.3 million women diagnosed with breast cancer and 685,000 deaths globally. As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past five years, making it the world’s most prevalent cancer.

According to the American Cancer Society, there were an estimated 287,850 new cases of invasive breast cancer among women in the USA in 2022. In addition, 43,250 women died from the disease.

An estimated 51,400 cases of non-invasive ductal carcinoma in situ (DCIS) will be diagnosed among women. Although breast cancer is predominantly female, approximately 2,710 new cases and 530 deaths (about 1% of all breast cancer cases and deaths) will occur among men.

Fortunately, most individuals with early breast cancer become long-term survivors, according to new British research that finds a substantial reduction in the risk of death since the 1990s.

First, though, I want to explore the fascinating history of breast cancer. We begin in ancient Egypt.

Breast Cancer — Ancient History

Breast cancer has a long and complex history that spans centuries. Understanding and managing breast cancer has evolved significantly, improving diagnosis and survival rates.

Breast cancer has been documented since ancient Egypt, around 1600 BCE. The Edwin Smith Papyrus, an Egyptian medical text, mentioned a condition characterized by bulging tumors in the breast.

The treatment options during this time included cauterization or completely removing the affected breast.

Photo by Patrick on Unsplash

Classical Antiquity

During the classical period, the Greek physician Hippocrates (460–370 BCE) referred to breast cancer as “karkinos” and described the spread of the disease to nearby lymph nodes.

He proposed that an imbalance of bodily fluids caused breast cancer. Surgical intervention was still the primary treatment, involving radical mastectomy or acidic substances to destroy the tumor.

Middle Ages

In the Middle Ages, breast cancer was often associated with superstitions and mysticism. It was believed to be caused by supernatural forces or punishment for immoral behavior.

Treatments included various herbal remedies, poultices, and even incantations. Surgery was rare and generally not recommended due to the high risk of infection.

Renaissance and Enlightenment.

During the Renaissance, medical knowledge and understanding of breast cancer advanced.

In the 16th century, French surgeon Ambroise Paré introduced a less invasive method of surgery called the “horizontal incision,” which spared the chest wall muscles. This technique reduced complications and improved outcomes for patients.

Breast Cancer in the 1700s and 1800s

18th and 19th Centuries

The 18th and 19th centuries witnessed significant progress in understanding breast cancer.

In 1775, the Scottish surgeon Benjamin Bell advocated for early diagnosis and surgical intervention, recommending lumpectomy (partial breast removal) instead of radical mastectomy. However, many surgeons still favored aggressive procedures.

In the 19th century, advances in anesthesia and aseptic techniques improved surgical outcomes. William Stewart Halsted, an American surgeon, introduced radical mastectomy in the 1880s, which involved removing the entire breast, underlying chest muscles, and axillary lymph nodes.

Radical mastectomy became the standard treatment for several decades despite its physical and psychological impact on patients.

Breast Cancer in the 1900s

20th Century

The 20th century brought further advancements in breast cancer research and treatment. In the 1940s, the use of X-rays for diagnostic purposes became widespread. This development led to mammography in the 1960s, revolutionizing early detection and screening efforts.

In the 1970s, the discovery of estrogen receptors in breast cancer cells led to the development of hormone therapies. Tamoxifen, a selective estrogen receptor modulator, became the first FDA-approved drug for breast cancer treatment in 1977.

Breast ultrasound. Adobe Stock Photos.

Advances in imaging technologies, such as ultrasound and magnetic resonance imaging (MRI), provided additional tools for diagnosing and staging breast cancer.

In the 1980s, fine-needle aspiration biopsy allowed for less invasive and more accurate diagnosis.

Recent Advances in Breast Cancer Management

The 21st century brought significant progress in understanding the genetics of breast cancer. The discovery of BRCA1 and BRCA2 genes, which increase the risk of developing breast and ovarian cancer, provided valuable insights into the hereditary component of the disease.

Genetic testing and counseling have become important tools for risk assessment and personalized treatment planning.

Targeted therapies, such as Herceptin (trastuzumab), were developed to target breast cancer cells that overexpress the HER2 protein specifically. These treatments have shown remarkable efficacy, improving survival rates for HER2-positive breast cancer patients.

Surgery advances

Furthermore, advancements in surgical techniques, including breast-conserving (lumpectomy) and oncoplastic surgery, have improved cosmetic outcomes while ensuring effective cancer removal.

Today, breast cancer research continues to focus on personalized medicine, immunotherapies, targeted therapies, and early detection methods.

Public awareness

Public awareness campaigns and improved access to screening have contributed to earlier diagnoses and improved survival rates for breast cancer patients.

While breast cancer remains a significant health challenge, the ongoing efforts of researchers, healthcare professionals, and advocacy organizations are steadily advancing our understanding and treatment of this disease.

Breast Cancer is Common

Breast cancer remains a significant concern for women worldwide, impacting millions of lives annually.

Did you know women lose more disability-adjusted years to breast cancer than any other cancer type? Breast cancer occurs in every country and women (and, far less commonly, men) at virtually any age.

Most with breast cancer are diagnosed after puberty but with increasing rates in later life.

Photo by Алекс Арцибашев on Unsplash

There was little change in breast cancer mortality from the 1930s through the 1970s. Fortunately, early detection programs combined with improved management tools led to survival improvements beginning in the 1980s.

However, recent research has brought forth an encouraging revelation: the vast majority of women diagnosed with early-stage breast cancer are likely to become long-term survivors.

This finding offers hope and underscores the tremendous progress in understanding, diagnosing, and treating breast cancer. Let’s explore the implications of this discovery, highlighting the key factors contributing to improved survival rates and the importance of continued research and support for breast cancer patients.

Breast Cancer Survival Rates Rising

Breast cancer treatment has witnessed remarkable advancements in recent decades, significantly improving the prognosis for patients.

The advent of early detection through widespread mammography screening programs has played a crucial role in identifying breast cancer at its nascent stages, enabling timely intervention and treatment. As a result, most breast cancer cases diagnosed today are at an early stage, where the tumor is confined to the breast or nearby lymph nodes.

Treatment modalities have evolved significantly in conjunction with early detection, incorporating a multidisciplinary approach tailored to each patient’s unique circumstances.

Surgery, radiation therapy, chemotherapy, targeted therapies, and hormone therapy are among the arsenal of treatments employed in breast cancer management. The personalized nature of these treatments ensures that patients receive the most appropriate interventions based on the characteristics of their cancer, such as hormone receptor status, HER2 status, and genetic mutations.

Research Fuels Breast Cancer Advances

The progress achieved in breast cancer treatment owes much to ongoing research and clinical trials. Scientists and medical professionals continuously strive to unravel the intricacies of breast cancer biology, leading to the development of novel therapeutic strategies and precision medicine approaches.

Clinical trials provide a platform for testing innovative treatment modalities, ensuring patients receive the most cutting-edge care. By participating in clinical trials, women with early breast cancer contribute to expanding the body of knowledge and improving outcomes for future generations.

Prognostic Factors for Survival

Various factors influence the prognosis for women diagnosed with early breast cancer. Several clinical and biological indicators are considered to predict the likelihood of long-term survival.

These include the following:

  • Size and grade of the tumor
  • Lymph node involvement
  • Hormone receptor status
  • HER2/neu overexpression
  • Specific genetic mutations.

Determining these factors assists clinicians in devising optimal management plans and tailoring interventions based on individual patient needs.

Moreover, advancements in molecular diagnostics have led to the emergence of gene expression profiling tests, such as Oncotype DX and Mammaprint.

Photo by THAVIS 3D on Unsplash

These tests analyze the activity of specific genes within the tumor and provide valuable information on the likelihood of disease recurrence and the potential benefit from chemotherapy.

By utilizing these predictive tools, healthcare providers can guide patients toward the most appropriate treatment decisions, reducing unnecessary interventions and focusing on therapies with proven efficacy.

Good News From a New Study

Receiving a breast cancer diagnosis can be devastating. Fortunately, most individuals diagnosed with early breast cancer become long-term survivors. That’s the finding of a new study in the British Medical Journal that reports the following:

There has been a substantial reduction in the risk of death since the 1990s.

The news is reassuring as a radiation oncologist specializing in breast cancer. The findings are also good news for most early breast cancer patients.

In the late 1900s, the average risk of dying from breast cancer (within five years of diagnosis) was 14 percent. Today, it has dropped to five percent. More than six in ten women diagnosed from 2010 through 2015 had a five-year risk of three percent or less.

The study authors analyzed National Cancer Registration and Analysis Service data for over 512,000 women diagnosed in England with early breast cancer between January 1993 and December 2015.

Early breast cancer is defined as confined to the breast or spreading only to the underarm (axillary) lymph nodes.

Breast Cancer: We Still Have Work to Do

The risk of breast cancer-related death was under three percent for nearly two-thirds (63 percent) of women, but it was over 20 percent for five percent.

While the increasing survival rates for women with early breast cancer offer tremendous hope, it is essential to acknowledge the psychosocial aspects of the disease.

Breast cancer diagnosis and treatment can profoundly impact a woman’s woman’s well-being, body image, and overall quality of life. Therefore, providing comprehensive psychosocial support to the patient’s crucial.

Supportive care programs, survivorship initiatives, and counseling services are vital in addressing breast cancer survivors and their psychological needs. These programs facilitate the adjustment to life after cancer treatment, helping individuals cope with anxiety, depression, and body image concerns.

By fostering a holistic approach to care, healthcare providers can empower survivors to embrace their new normal and live fulfilling lives beyond their breast cancer diagnosis.

Continued Research and Awareness are Key

While the latest findings on long-term survival rates in early breast cancer cause celebration, it is imperative to remember that breast cancer remains a significant global health challenge.

Continued research is vital to unravel the complexities of the disease, identify new therapeutic targets, and improve treatment outcomes for all patients. Robust support for breast cancer research initiatives and awareness campaigns is necessary to maintain the momentum in the fight against this formidable adversary.

Key points — A Triumph of Science: Breast Cancer Survival

Question. Can most women with early breast cancer expect to become long-term survivors? How much has survival improved recently?

Findings. In the late 1900s, the average risk of dying from breast cancer (within five years of diagnosis) was 14 percent. Today, it has dropped to five percent. More than six in ten women diagnosed from 2010 through 2015 had a five-year risk of three percent or less.

The study has its challenges. The findings were observational and can’t elucidate the causes of these reductions in death rates. Information on cancer recurrence was not available.

Another limitation is the current report focused on patients initially treated with surgery, not those treated with drugs (such as chemotherapy or anti-HER2 medicines) to reduce the size of their cancer before surgery or those whose cancer had already spread.

Final Thoughts: Breast Cancer Survival

Improved survival rates are likely the combination of early detection through mammography screening programs, advancements in management, personalized medicine approaches, and the contributions of bench research and clinical trials.

Meaning. Fortunately, most individuals with early breast cancer become long-term survivors, according to new British research that finds a substantial reduction in the risk of death since the 1990s.

The risk of breast cancer-related death is now under three percent for nearly two-thirds (63 percent) of women, but it was over 20 percent for five percent. We have made great progress, but we have much to do.

Improved survival rates can be attributed to early detection through mammography screening programs, advancements in treatment modalities, personalized medicine approaches, and the contributions of research and clinical trials.


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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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