Breast Cancer Death Rate Drops in Britain (dateline September 19, 2000)

Deaths from breast cancer have declined significantly in the 1990s in Britain, according to a new study released by the Institute of Cancer Research. Researchers attribute the 21% decrease in breast cancer deaths to a national breast cancer mammography screening program that was implemented in the late 1980s. Better treatments, such as chemotherapy and the drug tamoxifen, also contributed to the decline in breast cancer deaths in England and Wales. Further declines in breast cancer deaths are expected in the next 10 years, according to the researchers.

In recent years, researchers have debated whether the decline in breast cancer deaths in the U.S. and in Europe was due to improved treatment options or to increased breast cancer screening. According to researcher Sue Moss, associate director of the Institute of Cancer Research, and her colleagues, both screening and better treatments have contributed to the decline in breast cancer deaths between 1990 and 1998 in Britain.

According to the study:

• Treatment accounted for 14.9% of the decline in breast cancer deaths.
• Britain’s national screening program accounted for 6.4% of the decline in breast cancer deaths (under Britain’s national screening program, women between the ages of 50 and 64 are eligible for screening mammograms every three years).

Moss and her colleagues believe that improvements in breast cancer screening will lead to an even greater decrease in breast cancer deaths in the next decade. "Since the early years of screening there have been substantial improvements in sensitivity, particularly for small invasive cancers, as a result of the increased use of two view mammography, the use of higher film densities, and increasing experience of radiologists," wrote the researchers in their report.

The researchers also attribute the increased use of the drug tamoxifen to helping lower the breast cancer death rate in Britain. Tamoxifen is used to help treat early and advanced stages of breast cancer, prevent breast cancer recurrence (return), and prevent breast cancer in women at high risk for the disease. Improvements in chemotherapy regimens and other treatments have also contributed to the decline in deaths from breast cancer, wrote the researchers.

As in Britain, the breast cancer death rate also declined significantly in the United States in the 1990s, with the largest decreases among younger women. In the U.S., the American Cancer Society, the American College of Radiology, the American College of Surgeons and the American Medical Association all recommend that women begin receiving annual mammograms at age 40.

Guidelines for the early detection of breast cancer:

• All women between 20 and 39 years of age should practice monthly breast self-exams and have a physician performed clinical breast exam at least every three years.
• All women 40 years of age and older should have annual screening mammograms, practice monthly breast self-exams, and have yearly clinical breast exams.
• Women with a family history of breast cancer or those who test positive for the BRCA1 (breast cancer gene 1) or BRCA2 (breast cancer gene 2) mutations may want to talk to their physicians about beginning annual screening mammograms earlier than age 40, as early as age 25 in some cases.

Additional Resources and References

• The medical study, "Effect of NHS Breast Screening Programme on Mortality From Breast Cancer in England and Wales, 1990-8: Comparison of Observed with Predicted Mortality," is published in the September 16, 2000 issue of the British Medical Journal. The study is available online at http://www.bmj.com/cgi/content/full/321/7262/665
• To learn more about breast cancer screening and guidelines for early detection, please visit http://www.imaginis.com/breasthealth/earlydetection.asp