Time to Talk about Breast Cancer Statistics

Being diagnosed with breast cancer can be a terrifying prospect, but the fact is that breast cancer remains the second most common cancer in the U.S. for women.

Breast cancer affects 1 in 8 women in America  (1 in 9 in Canada) and the problem is only growing.

Alarmingly, 85% of breast cancers are diagnosed in women with no previous family history of the cancer. But if there is a family history of breast cancer in a first relative, (mother, sister or daughter,) the risk of cancer doubles. In fact 15% of all women diagnosed will have a family member with the disease, so effective screening and self-checking is highly recommended.  Prevention is better than cure.

But it’s not just women who are suffering. Breast cancer in men is growing, and in 2011, 2,140 new cases of invasive breast cancer were diagnosed, making the lifetime risk of developing the disease 1 in 1,000. While this number still pales in comparison with the statistics for women, it highlights the fact that breast cancer is not confined to a single gender.

Breast Cancer Survivors

But it’s not all bad news. Between 1999 and 2005, there was a steady 2% decrease in breast cancer incidence rate in America, seen in the most common age group (women aged 50 and over). Medical professionals have recognised that this might be due to women shunning the Hormone Replacement Therapy, after it was linked to breast cancer risk in a report from 2002.

Out of the 230,480 people diagnosed with breast cancer in 2011, 39,520 were expected to die of the disease – but this rate is much lower than the equivalent in 1990. It is thought that a combination of earlier detection, screening treatments, and increased awareness has lead to the drop in the statistics.

A woman diagnosed today will have a good chance of surviving the disease for at least 10 years, with two thirds surviving for over twenty years. The key to beating the cancer is an early diagnosis.

Once assessed and diagnosed with the help of medical imagery software, a patient will often be offered an array of different courses of treatment from various health care professionals, including pathologists, oncologists and surgeons, and the decision making process can be very confusing.

I would personally choose to trust the professionals to decide what’s best for me, rather than being given the reins of the decision making. But while it would be best is if all the professionals sat down together and presented their thoughts and suggestions to the patient, it seems like this rarely happens.

Dialogue Amongst Professionals

This multidisciplinary collaboration is not only key to informing the patient fully, but also a great way for medical professionals to bounce ideas off of one other.

However, a recent study published by the International Journal of Radiation Oncology*, has found that radiation oncologists are actually sometimes excluded from the early decision making process in breast cancer treatment, even if they have findings that could be important to the overall decision.

The Managing Director of the department of radiation oncology at University of Michigan, Reshma Jagsi, conducted a study into the frequency and timing of consultations between the radiation oncologists and the surgeons, using a survey of four main questions.

1. When do radiation oncologists get involved in the care of the new breast cancer patient?
2. Are they involved at the appropriate time?
3. Would they say that this constitutes a co-ordinated care package for the patient?
4. During a case meeting, how often do surgeons and radiation oncologists opinions differ on management of treatment?

Jagsi used a sample of 419 surgeons and 160 radiation oncologists based in Los Angeles and Detroit, and 76% of surgeons and 73% of radiation oncologists responded to the survey’s questions.

Of these totals, 92% of the surgeons and 95% of the radiation oncologists said that they were in theory part of a multidisciplinary tumor board, but up to 28% of these said that in practise, their colleagues in other departments were not involving them early enough in the decision making process.

Radiation oncologists also had difficulties in other areas, such as being able to discuss the patient’s treatment with a plastic surgeon, arranging to have pathologists take a look at pathology slides, and also getting mammograms reviewed efficiently by a radiologist.

This does have far reaching consequences for patients, as radiation oncologists would be more likely to suggest post mastectomy radiation therapy for N1 disease stage patients, but surgeons on the other hand were more likely to require wider margins of resection for breast conserving therapy.

[box type=”note”]Certainly, the report highlighted that there is potential for improvement in this area of cancer care, and it would benefit the patient if same-day multidisciplinary clinics could be set up and used more frequently by all involved.[/box]

Reference

• Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study