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Hopeful signs for breast cancer patients

In response to some viewer e-mails, I would like to provide more details about a report we had on breast cancer on Wednesday night.

Our report was based on a study published in the New England Journal of Medicine that looked at the reasons for some good news in the battle against breast cancer. Until 1990 the death rate for breast cancer had been going up. But since 1990 it has been falling about two percent a year. The reasons for this hopeful trend had been a medical mystery.

Researchers looked at seven separate statistical analyses of the trend and concluded two factors were responsible. The first was regular mammograms. An increasing numbers of women have been getting screening mammograms and as a result doctors are finding ever more breast cancer at earlier, more curable stages. There has been a big debate whether mammograms save lives and these results should end that argument.


But the study found that just as important was a change in the way breast cancer is treated for many patients.  Increasingly, women with breast cancer get what is called adjuvant therapy. This can be hormone therapy, chemotherapy or both. It is administrated soon after the removal of the tumor. The point is not to treat cancer that is there, but to keep the cancer from coming back. The studies showed that adjuvant treatment is at least as important, possibly more so, than regular mammograms in bringing down the overall death rate.

But I want to emphasize that this study was not about any particular chemotherapy or hormone drug. It showed how trends in medical care are affecting the overall death rate. It does not contain any information on what specific treatments a woman with breast cancer should be receiving.

It certainly does not mean that every woman diagnosed with breast cancer should be getting adjuvant chemotherapy or hormone treatment. Breast cancer experts say one of the biggest problems they face now is that many more women get the treatment than actually need it. That approach is helping to bring down the overall death rate, but many suffer the side effects of the treatment unnecessarily. The hope is that genetic tests will soon identify those patients who will actually benefit from adjuvant therapy.

And finally, while it is wonderful to see the breast cancer death rate falling, we need to remember that 40,000 women in this country will die from breast cancer this year. While there is progress, the research still has a long way to go.