There are currently 3.8 million women with a history of breast cancer living in the United States. Since 1989 the death rate has plunged 40%. According to the American Cancer Society (ACS), these gains have begun to slow. Spokesmen for the ACS suggest that the slowing of the plunge in death rate can likely be attributed to a saturation of significant treatment advances through the oncology community. Also, the lack of new blockbuster drugs may play a role. This latest data includes 5 years from 2012-2016.

According to a large national database, the death rate from breast cancer from 1998-2011 declined by about 1.9%. Unfortunately, it has now slowed to 1.3%.

During this same period, the incidence of breast cancer has risen by 0.3%, mostly accounted for by early-stage cancer as well as hormone-positive (estrogen and progesterone receptor-positive) tumors. Spokesmen for the ACS attribute this increase in hormone-positive tumors to the increase in women with excess body weight and decrease in fertility rates.

It is interesting to look back at the rate of DCIS, which increased 11-fold from 1980-2008. It then decreased slightly by 2.1% from 2012-2016. The dramatic rise in the incidence of DCIS was attributed to the rising trend of screening mammography. The slowing of the rise occurred when mammography had become the routine screening test for most women.

Though cancer incidence is slightly lower for African-American women, the death rate, as before, remains 40% higher (28.4 vs 20.3 deaths per 100,000 women). Breast cancer was the leading cause of death for black women (2016-7) in 6 states: Arizona, Colorado, Florida, Georgia, Mississippi, and South Carolina. It was the leading cause of death among white women in Utah.

Carol DeSantis of the American Cancer Society noted that optimal breast cancer treatment has largely been available to white women in the US which may explain part of the slowdown in mortality gains. She added that “More can and should be done to ensure that all women have access to quality care to eliminate the disparities and further reduce breast cancer mortality.”

Alan Stolier