Catching breast cancer early still saves lives, even with better treatment such as targeted drugs, Dutch researchers reported Tuesday.
The findings support the use of regular mammograms to detect breast tumors at the earliest possible stages, other experts argued. And the new research is reassurance that less-invasive surgery saves lives just as well as radical mastectomies would.
It also demonstrates that consistent, high-quality care matters. The breast cancer survival rate in the Netherlands is 96 percent and it’s 100 percent for the smallest tumors, the researchers noted. The five-year breast cancer survival rate in the U.S. is 90 percent.
“Diagnosis of breast cancer at an early tumor stage remains vital."
The Netherlands team, led by Sepideh Saadatmand of the Erasmus University Medical Center, studied every breast cancer case registered in the country from 1999-2012 —nearly 174,000 cases.
Before 2006, the breast cancer survival rate was 91 percent. After that, it was 96 percent, they reported in the British Medical Journal.
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Women survived longer after 2006 because the tumors were smaller when they were removed and less likely to have spread, they reported. Yet during this time less-invasive surgery such as lumpectomies became more common.
“Diagnosis of breast cancer at an early tumor stage remains vital,” they concluded.
This suggests that mammograms are saving lives, argued Dr. Ines Vaz-Luis and Dr. Harold Burstein of the Dana Farber Cancer Institute and Harvard Medical School.
“Of late, there has been debate about whether mammography saves lives or whether, in a modern era of effective therapy, detecting cancers when they are smaller makes any meaningful difference to patients,” they wrote in a commentary.
“Saadatmand and colleagues’ study does not specifically answer the question. But it strongly suggests that, even after accounting for biological variation in tumors and enhanced treatments, tumor stage at diagnosis still matters. That is a powerful albeit indirect argument in favor of screening mammography,” they added.
“Catching cancers when they are smaller still makes a difference.”
Mammograms are a controversial issue in the U.S. — not whether to get them at all, but at what age and how often to get them.
"That is a powerful albeit indirect argument in favor of screening mammography."
The American Cancer Society says women over 40 should get a mammogram every year. The U.S. Preventive Services Task Force, which advises the federal government, says women over 50 should get a mammogram every other year. It says women 40 to 49 should decide what they want, based on their health history, and it's not clear if women over 75 should bother with mammograms. The latest study showed that Dutch women over 75 were living longer when their tumors were diagnosed earlier.
Several studies have suggested that routine mammograms don't necessarily save women's lives, even if they detect breast cancer earlier. The Netherlands study may contradict that finding.
The American Cancer Society estimates that more than 230,000 U.S. women will be diagnosed with breast cancer this year; that 40,000 women will die from it and that one in eight women will be diagnosed at some point in their lifetimes.