Though treatment has advanced, smaller tumors linked to better outcomes
We’ve made significant strides in breast cancer treatment in recent years, including “targeted” drugs such as Herceptin that zero in on specific abnormal proteins found in certain breast tumors; wider use of hormonal therapies that lower the risk of a breast cancer recurrence; and better chemotherapy regimens. But according to a new study, a woman’s chances of survival still depend on early detection.
The study, of nearly 174,000 Dutch breast cancer patients between 1999 and 2012, found overall survival rates improved, including among women with more advanced cancer. But survival odds were best when women’s tumors were caught early.
“The general prospects for a woman diagnosed with breast cancer in the Western world are very good,” said lead researcher Madeleine Tilanus-Linthorst, M.D., of Erasmus University Medical Center in the Netherlands.
Researchers found an 88 percent five-year survival rate among women diagnosed with breast cancer between 2006 and 2012. That figure is up from 83 percent among women diagnosed with the cancer between 1999 and 2005. The increased survival rate extended to women with more advanced cancer. Among those with larger tumors—more than 2 inches across—the research revealed the five-year survival rate rose 10 percentage points, from 63 percent to 73 percent.
But the smaller a woman’s tumor at diagnosis, the better the outcome, the study found. Of women diagnosed in more recent years, nearly all survived at least five years if their tumor was caught when it was less than three-quarters of an inch across. In fact, their five-year survival rates were comparable to those of an average woman their age who’d never been diagnosed with breast cancer.
“Catching the cancer early is still highly important,” Dr. Tilanus-Linthorst said.
Of the women diagnosed between 2006 and 2012, she noted, 65 percent had their tumors caught when they were still less than three-quarters of inch in size, suggesting size does matter.
In this study, women diagnosed with breast cancer in more recent years were more likely to receive the latest therapies. They were also more likely to receive “breast conserving” surgery—where only the tumor and some surrounding tissue are removed—and less likely to undergo a radical mastectomy. But even with these new treatments, tumor size at diagnosis remained a key factor in a woman’s outlook.
This is key because it points out the benefits of mammograms, something that has been debated lately, especially for women younger than 50. The American Cancer Society and some other groups suggest yearly mammograms starting at age 40. The U.S. Preventive Services Task Force, however, issued guidelines suggesting that women begin screening at age 50, and continue every two years to reduce the worry caused by false-positive mammogram results, lessen invasive testing and prevent unnecessary treatment.
It should be noted that black women are more likely to develop aggressive, hard-to-treat breast cancers at younger ages than their white counterparts. And though we’re diagnosed with breast cancer less than white women, we have higher death rates from the disease.