Good News In Breast-Cancer Detection, Care

If you think you've been hearing a lot more positive news about breast cancer care and prevention, you're right. And if you support prevention and research efforts, you're part of the reason.

"Improvements in detection and in treatment of breast-cancer have definitely shown a benefit in the past few years," says Robert A. Smith, Ph.D., director of cancer screening at the American Cancer Society's national office in Atlanta.

Latest statistics from the National Cancer Institute show that the breast-cancer mortality rate for all women has declined by about 2 percent per year since 1990.

Overall, the risk of breast cancer has remained relatively stable over the past 10 years; one in eight women still develops it. A woman's chances for recovery, however, have been looking better. Among those diagnosed between 1974 and 1976, for example, about 75 percent were alive after five years. Among those diagnosed today, the five-year survival rate has jumped to 85 percent.

Catching it early

Why are more women surviving breast cancer? "Mostly it's because the disease is being detected earlier," says Dr. Smith. "Breast cancer takes many different forms, and some are more aggressive than others. The fundamental key to a good prognosis is finding it early so you have the greatest range of treatment options."

Mammograms are still the "gold standard of early detection, and the good news is that more women are getting them regularly," says Dr. Smith.

Physicians can also utilize other imaging equipment to evaluate possible areas of concern. For example:

• Ultrasound uses high-frequency sound waves to help determine whether a mass is a solid tumor or a cyst.

• MRIs sometimes are used to detect small residual tumors after surgery and to monitor breast implants for leakage.

When a mammogram reveals an abnormality, doctors now can perform minimally invasive core biopsies using a slender, hollow needle to gather several samples from different areas of the tissue.

Women diagnosed with breast cancer also benefit from new drug therapies. Tamoxifen, the best known, reduced the recurrence of breast cancer very effectively during clinical trials. As a result, the government has approved it for use by women at high risk of breast cancer to reduce their chances of developing it.

In 2005, experts announced that the drug Herceptin (trastuzumab) seems to reduce the risk of a recurrence of breast cancer in women whose tumors have too much of a protein, called HER-2. HER-2 positive cancers tend to grow faster and are more likely to return after treatment than cancers that don't have too much of the protein.

Making good decisions

In addition, researchers are zeroing in on lifestyle factors that affect breast cancer. "We're feeling more and more confident that we can give women information they can use to make decisions that can reduce their risk," says Dr. Smith.

The following are factors that seem to increase the risk of breast cancer:

• Alcohol. Drinking more than two drinks a day.

• Postmenopausal obesity. Though a high-fat diet isn't considered a risk factor, obesity has been associated with a higher risk.

• Hormone-replacement therapy. Over the long term, it produces a slightly elevated risk of breast cancer, which must be weighed against a decreased incidence of hot flashes and other post-menopausal symptoms

Other factors are associated with lower breast-cancer risk:

• Lactation. Breast-feeding seems to help protect against breast cancer.

• Physical activity. In addition to controlling obesity, regular exercise appears to have independent risk-reducing benefits.

By far, however, early detection by regular mammograms in conjunction with annual breast exams are the best way to reduce your risk.

"Right now, there's a 96 percent survival rate for women with breast cancers that are detected while they are still localized," says Dr. Smith. "Compared with other cancers, breast cancer is one of the more survivable."