Better screening aids breast cancer survival rates

Two-thirds of women who are diagnosed with breast cancer today can expect to survive for at least 20 years, according to figures from a cancer epidemiologist. The screening programme, which picks up tumours early, and better treatment with innovative drugs have contributed to the steady rise in survival rates in the UK, said Michel Coleman of Cancer Research UK, but it is too early to know whether Britain's survival rates have caught up with the best of those in Europe.

There are more than 41,000 diagnoses of breast cancer every year. Professor Coleman predicts, based on analysis of the trends over a decade, that 64% of all women diagnosed from 2001-03 with breast cancer will still be alive in 20 years' time. That is an increase from 44% of those diagnosed in 1991-93 and 52% of those diagnosed in 1996-98.

The 10-year survival rate for today's newly diagnosed women will be 72%, he says. In 15 years, 67% will be alive.

Among the 50-69-year-olds, who get regular screening and are the group most likely to get breast cancer, the rates are better. In 20 years' time, 72% of them will have survived.

Younger women tend to have faster-growing, more aggressive cancers that are not easily detectable because of the density of the breast tissue before the menopause, so their survival rates are not quite so good, although they are also improving. The drug Herceptin, which has been the subject of much controversy since it is not yet universally available in this country, is expected to be particularly useful in the treatment of young women.

"Overall long-term survival for women with breast cancer has improved dramatically over the last 10 years and we are seeing even better survival statistics for women in their 50s and 60s," said Prof Coleman.

He said earlier diagnosis through screening and more awareness among women that they should check their breasts and see a doctor if they discover a lump had contributed to the rising survival rates. Treatment had also improved: there was better surgery from surgeons who specialised in breast cancer, more radiotherapy and better cancer drugs. "These changes in treatment are feeding through into our predictions of long-term survival," he said.

The figures represent an increase in survival times of 17-20% since the early 1990s. Prof Coleman said they should continue to get better if some anomalies are addressed, such as the better prospects for wealthier women and some fairly minor regional differences.

Comparable figures are not yet available for other European countries, but at the last count two years ago, the UK was still behind the best. "We need to catch up further with western Europe," Prof Coleman said. "That is part of the NHS cancer plan." Other countries that are doing particularly well include the Nordic countries, Switzerland and France, he said. "They have higher survival rates partly due to earlier diagnosis."

Tony Howell, Cancer Research UK consultant medical oncologist at the Christie hospital in Manchester, said the figures were "clearly an extraordinarily important result for women. In the clinic we can say you have more chance of dying of something else than you have of dying of your breast cancer."

He said the improvements were "a triumph for the NHS", which had introduced the breast screening programme, specialist surgeons and multi-disciplinary teams to care for women with the disease.

"This is great news for anyone whose life has been affected by a breast cancer diagnosis," said Sarah Rawlings, head of policy at the charity Breakthrough Breast Cancer. "Early detection, better awareness and improved breast cancer treatments are all to thank for these dramatic improvements. If we want to improve these survival rates even further then rapid access to diagnosis and treatment are key, but ultimately what we would really like to see is breast cancer becoming a preventable disease."