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One in eight women will suffer breast cancer, and 83% will survive, says AECC
INTERNATIONAL Breast Cancer Day meant social media was flagged with pink loops today (Thursday), and Spain's national research and care charity, the AECC, has described ground-breaking research that means survival rates are constantly rising.
Breast cancer affects around 27,000 women in Spain per year – a total of 27,747 cases were detected in 2015 – and is expected to rise by 11% in 2020 to 28,000 and by 17% in the year 2025, to 29,500 per year, and one in eight women will be diagnosed at some point in their lives, typically between the ages of 35 and 80 but in the vast majority of cases, between 45 and 65, an age group given routine bi-annual mammograms in Spain.
Three female cancer patients in every 10 have breast cancer, which is the most-diagnosed type in the world and the fourth-most in Spain, behind lung, stomach and bowel cancer, according to the Spanish Medical Oncology Society (SEOM).
The AECC says rising numbers worldwide are partly due to earlier diagnosis and because people are living longer and, although concrete figures are unavailable, it is thought the incidence is about 1% or 2% of the population; a similar proportion to the USA.
Men also suffer breast cancer - it is extremely rare and barely reaches 1% of cancer diagnoses in males, but costs 75 men their lives annually in Spain, says the Carlos III Health Institute. It is the main cause of death among women, claiming 6,000 female lives per year, or 16.7% of all female cancer deaths in the country and 3.3% of the female mortality rate. The average age of death from breast cancer in Spain is 66, in both sexes, although survival rates rise by around 1.4% per year.
Survival is measured by who is still alive five years after diagnosis, since by then it is considered that if the cancer 'returns', it is a different cancer altogether rather than the original one. At present, 82.8% of women in Spain survive breast cancer, which is above the European average and similar to some of the countries with the best cure rates in the world. In total, 25,215 of women were diagnosed with breast cancer in 2012, and 6,075 have since died.
The AECC says that whilst diagnoses are rising, mortality rates are stabilising, if not dropping, due to a combination of early detection and better treatment, but there is still a long way to go, says the scientific association GEICAM, given that 30% of women diagnosed early will still find their cancer comes back and has spread, which means their chances of survival are dramatically reduced.
The average woman whose breast cancer returns and metastasises will live for another 2.3 years, compared with 2.8 years for those who are diagnosed with metastatic breast cancer from the start.
An increase in cases diagnosed in women aged under 45 has been detected in recent years, according to GEICAM – a factor the association attributes to women leaving it until much later to have their first child, a reduction in the number of children per woman, and girls starting their first periods at younger and younger ages.
One of the crucial aspects of breast cancer which, if solved, could greatly increase cure rates, is that the tumours are made up of multiple parts, all of which need different types of drug to treat them, according to the AECC's research leader, Dr Marta Puyol.
“Often, samples taken during biopsies only include one aspect of the tumour, meaning any other components within it go undetected – and this would explain how some of them appear to be resistant to treatment,” Dr Puyol says.
Currently, the AECC has 16 research projects under way relating to breast cancer, involving an investment of €3.6 million, and Dr Puyol says the vital issue is 'ensuring you classify the tumour type very accurately', since this means the treatment is more effective.
One of the main lines of research at the AECC is focusing on HER2-type tumours which 'in the past, were the most aggressive', Dr Puyol explains, but that now, thanks to a recently-discovered new drug which targets this type of tumour cell directly, around 70% of patients are responding to treatment, with the remaining 30% showing resistance; the latter 30% are the ones the AECC is studying.
Nowadays, the most aggressive type is the so-called 'triple negative', and so far, no specific treatment has been discovered, meaning patients are given 'standard' chemotherapy at present. Scientists are researching more 'personalised' medicine using biomarkers to create a specific type of treatment tailored accurately to the individual patient, says Dr Puyol.
She also reveals that immunotherapy, another major cancer treatment breakthrough, is not quite such a strong bet for breast cancer as in other types of the disease, such as lung or skin, but that research is focusing heavily on its use for triple-negative tumours and certain sub-groups which may benefit from it in combination with chemotherapy and radiotherapy.
“This is going to be talked about a lot in the future,” alerts Dr Puyol.
Oncolythic virus present in cancer cells is one of the studies the AECC is giving a great deal of its attention to at the moment, the team leader says.
“We're studying a treatment that involves inserting a drug into the virus itself, only targeting cancer cells, leaving healthy ones alone,” Dr Puyol says. “Like this, we may be able to limit a lot of the toxicity and unpleasant side-effects, since chemotherapy kills off all dividing cells – healthy ones as well as infected ones.”
But the AECC is not expecting a vaccination against breast cancer to become a possibility any time soon – or even at all.
“I can't see it right now,” Dr Puyol admits. “A global vaccine for breast cancer wouldn't be possible because it's not just one disease you're trying to prevent – it's about 200 diseases. There are so many mutations and variations. Immunotherapy and accurate surgery are what's fundamentally important in increasing effectiveness of treatment and preventing recurrences.”
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