Fewer people are dying from breast cancer, according to a report from the American Cancer Society.
Overall mortality rates from breast cancer in the U.S. have fallen by 44% in the last 35 years, saving an estimated 500,000 lives.
The ACS report, released earlier this month, also underlines persistent racial disparities and the continued upward trend in new cases of breast cancer in women under the age of 50.
Margaret Gatti-Mays, MD, MPH, is section chief of Breast Medical Oncology at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, and an associate professor of medical oncology at The Ohio State University College of Medicine.
Rand: Let's start with the good news, that nationally, deaths from breast cancer remain on a long downward trajectory. What accounts for this great progress we're seeing?
Dr. Gatti-Mays: I think the progress is representative of women getting screening mammograms when appropriate. That really has had a large impact in those patients, because when we find the cancers earlier, they're smaller and they're easier to treat. But the other component is that our treatments have really advanced in the last five to 15 years. And so, we're starting to see better overall survival for our breast cancer patients.
Rand: How does our region compare to the rest of the country when it comes to breast cancer?
Dr. Gatti-Mays: The overall region is pretty comparable to the rest of the United States in terms of both incidents of breast cancer, as well as mortality.
Rand: The study also found that this progress has not been shared equally. American Indian and Alaska Native women have seen no improvement in death rates. Asian American/Pacific Islander women saw the fastest uptick in new cases at nearly 3%. And Black women still face a 38% higher mortality rate from breast cancer than their White peers. What accounts for these disparities?
Dr. Gatti-Mays: I think one of the main things that often people will point to is, especially in African American women, is that they tend to have later diagnoses and perhaps less access to high quality treatments. We also tend to see more aggressive breast cancer subtypes, like triple negative breast cancer, be overrepresented in African American women. That does make a difference. These more aggressive tumors tend to be more locally advanced at the time of diagnosis, but sometimes more challenging to treat as well.
Rand: What about the other part of this report, pointing to rising new cases of breast cancer in women under 50? What are you seeing?
Dr. Gatti-Mays: I have noticed in my own clinical practice here in Columbus that there really has been a larger number of younger patients than I've historically been used to treating. So as a breast cancer oncologist, I primarily treat or focus on triple negative breast cancer, which we tend to see in higher numbers in younger patients. But even if you think of breast cancer screening recommendations, most of the organizations at this point will recommend cancer screening starting at 40. We’re still seeing an increase in those patients under 40 who wouldn't necessarily get normal mammograms or routine mammograms. And so there I think there's something else going on. I think, you know, the cancer screening in mammograms is definitely helping with that—maybe earlier detection in the patients between 40 and 50 years old. But I think as an oncology community, we're really not quite clear what is causing this increase in younger women under 50, but specifically in those women under 40 years old.
Rand: What should folks be doing in light of this report to stay healthy?
Dr. Gatti-Mays: I think probably the No. 1 message for any of the listeners out there is for women to really know your body. You know, if something's not right, if you feel some pain, a mass, just notice a skin change, I really encourage patients to make sure that they're their own advocate. So, if you're noticing these changes, go to your primary care doctor. Try to make sure that this is assessed. Don't just write it off, saying ‘Oh, I’m too young to get breast cancer,’ especially if you're under the age of 40. In my cancer clinic, I really have come to the conclusion that cancer, especially breast cancer, really has no boundaries when it comes to younger age. And so, if something's different, something's wrong, make sure you're seeking appropriate care.
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