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Women are living longer with metastatic breast cancer: Why and what you should know

metastasis
Researchers discovered that despite the usual prognosis, more women initially diagnosed with metastatic breast cancer have been surviving the disease for longer periods of time, especially women diagnosed at younger ages.

The number of women in the United States living with metastatic breast cancer has risen steadily over the past 25 years, by a total of about 50 percent. Experts say the marked increase is likely due to the aging of the U.S. population and improvements in treatment. "We have many more treatment options than we've ever had before," says Dennis Citrin, MD, PhD, Medical Oncologist at our hospital outside Chicago. "The science of oncology is light years ahead of where we were 30 or 40 years ago, when I started my career."

In the early 1990s, about 105,000 women were living with metastatic breast cancer, according to an analysis released earlier this year by the National Cancer Institute (NCI). This year, that number has jumped to nearly 155,000.

The disease, the most aggressive form of breast cancer, is progressive and does not typically go away with treatment.

“ Whenever we're dealing with cancer that's left the original site and has spread, it poses a challenge because simple surgical removal will not be enough. But metastatic breast cancer is not a hopeless situation.” - Dennis Citrin, MD, PhD - Medical Oncologist

To develop a more accurate estimate of the total number of women living with the disease, researchers used data from the NCI's Surveillance, Epidemiology, and End Results (SEER) Program.

Metastasis

The most common sites are:

  • bone
  • brain
  • liver
  • lung

Researchers discovered that despite the usual prognosis, more women initially diagnosed with metastatic breast cancer have been surviving the disease for longer periods of time, especially women diagnosed at younger ages.

The researchers estimated that between 1992-1994 and 2005-2012, the five-year relative survival rate among women initially diagnosed with metastatic breast cancer at ages 15 to 49 doubled from 18 percent to 36 percent.

Based on their calculations, the researchers also estimated that the number of women living with the disease increased by 4 percent from 1990 to 2000 and by 17 percent from 2000 to 2010. They project that the number will increase by 31 percent from 2010 to 2020.

One major improvement in breast cancer treatments was the introduction of trastuzumab (Herceptin®) in 1998 for treating certain tumors.

Targeted Therapy

Designed to attack specific genetic mutations found in some cancer cells.

Other targeted treatments have been developed since then, including one approved by the Food and Drug Administration last month. "The goal of treatment for someone with metastatic breast cancer is to essentially turn it into a chronic illness," says Dr. Citrin. "I always use the analogy of somebody with diabetes. Every day, a person gives herself an injection of insulin or takes a pill to control her diabetes. Day to day, she's still diabetic; she's not cured of her disease, but as long as she takes her medication on a regular basis, she is not going to die of her disease. Also, the disease is not going to cause severe symptoms to interfere with the quality of her life. That's really where we're at with metastatic breast cancer for a growing number of patients."