How far are we from curing breast cancer?

Paula Kerr / 21 October 2014

Find out diagnosis and treatment of breast cancer has developed over 30 years and how far we are from finding a cure.

Breast Cancer Campaign’s Chief Executive, Baroness Delyth Morgan and its Director of Research, Dr Lisa Wilde answer our questions:

How far has breast cancer care progressed over the last 30 years?

Lisa Wilde: "In the last 30 years, we've come an incredibly long way. If you look at the survival rate 30 years ago, you would have had a 50 per cent chance of being alive ten years after diagnosis. There is now a 77 per cent chance of being alive for ten years and longer. 

"Research has made a big difference.  In 1988, the breast cancer screening program was introduced, so we now have the means of making earlier diagnosis.

"We have better treatments available and we have a better understanding of breast cancer. Drugs like Herceptin and Tamoxifen weren't available for breast cancer patients 30 years ago and the BRCA1 and 2 genes hadn't been discovered." 

Despite years of research, why is there still no cure for breast cancer?

LW: "It's not just one disease. It's many diseases and presents in many different ways. There isn't a one size fits all approach to treatment.

"The more we discover about breast cancer, the more we still have to learn. The only way to get closer to a cure is with further research." 

What’s the biggest obstacle in finding a cure for breast cancer?

Delyth Morgan: "There are lots of things standing in the way. We need to keep scientific research going, at a pace. We need to have the NHS absolutely geared up to take those innovations and discoveries and turn them into treatments in hospitals as quickly as possible.

"We need to make sure that where there are NICE (National Institute for Health and Care Excellence) guidelines for dealing with patients, they are updated in line with new research findings." 

How close are we to finding a cure?

LW: "We're getting closer. There are gaps in our knowledge about breast cancer. For instance, some patients develop resistance to treatments over a period of time. We need to know why that happens.

"Talking to other scientists, there is hope that by 2050 breast cancer will be outlived and overcome." 

Why do other countries have a better survival rate than the UK?

DM: "In other countries, there is more intensive treatment of older patients, who are diagnosed earlier and followed up more aggressively. We have a very good NHS but it's slow on innovation and slow on early diagnosis. 

"The older you get, the more likely you are to develop breast cancer. It's important to promote early diagnosis and attend for screening when you're invited to.

"We are an ageing population and the likelihood of breast cancer increases with age, so we can expect to see more incidents.  Though with early detection, we also hope to see a decrease in mortality." 

Is there an argument for women being screened at a younger age?

DM: "One of the real challenges about screening is that younger women have dense breast tissue. Mammograms are not effective on dense tissue. Do we  want to screen a population of women in their thirties in those circumstances?

"However, there is an argument for screening women who have had abnormalities or a family history of breast cancer. We could also look at screening women beyond age 70, as we're an ageing population.

"When that age limit was introduced, the life expectancy was much less. You would potentially have more success with screening and treatment that way."

How close are we to replacing chemotherapy, affecting hair loss, fertility etc with targeted drugs?

LW:  "Over the last 30 years we have seen great progress in targeted drugs for breast cancer. We have Herceptin for HER2-positive breast cancer, we have aromatase inhibitors and Tamoxifen for oestrogen-receptor positive breast cancer.

"Though there are still breast cancers, like triple negative breast cancer, that don't have a targeted drug. We are looking for new drugs all the time and that's vital.

"Around a third of people who have chemotherapy will become resistant to it over time and if you are triple negative, that's your only option at present."

Which three things could improve breast cancer care?

DM: "We need ways to get NHS medical experts to co-ordinate better, to listen to their patients and design services in line with the latest medical research, as quickly as possible."

Is the NHS doing all it can?

DM: "There has been a lot of change in the NHS and an emphasis in improving cancer services. We need specialist clinical breast networks in every hospital, that can align radiotherapy, chemotherapy, screening and GP support. These are gradually being introduced, which is great. 

"There also needs to be greater support for those with secondary breast cancer, which has travelled to another part of the body, such as the liver, brain or bones, so they can go on to live full lives."

There are many breast cancer fund-raising events held every year. How is that money spent?

LW: "At Breast Cancer Campaign, we invest in high quality breast cancer research, by giving grants to scientists in the UK and Ireland. We give money to universities and research centres throughout the UK, that are affiliated to hospitals, not private companies.

"We also fund four tissue banks, which collect breast tissue from patients undergoing surgery, with their consent and make it available to researchers.

"We have collected 30,000 samples since we started in 2011. They are stored with notes on their make-up, but the donations are anonymous. It’s a precious resource, so we’re very careful how we distribute it."

LW: "We do it through our researchers. Scientists are fantastic at sharing their findings with other people because that’s how research develops. They publish data and hold conferences in Europe and the USA. We work closely with the other breast cancer charities, too. When NICE is considering a new treatment, we speak with one voice." 

In the last five years, has there been an increase or a reduction in male breast cancer?

LW: "Male breast cancer is showing signs that it has increased slightly, but not significantly. It was 360 cases a year and it's now 400. It's often found in older men and is usually genetically driven. It's rare."

What advice do you have for any readers worried about breast cancer?

LW: "Early diagnosis saves lives, so be breast aware. Know what's normal for you and as soon as you notice an abnormality, see your GP. 

"It's best to err on the side of caution. If you are over 50, make sure you attend breast screening. If you have any concerns, call one of the breast cancer charities, who will explain more."

Do you have any advice for readers living with breast cancer?

LW: “Living a healthy lifestyle is very helpful for people living with breast cancer, especially with regard to preventing it from returning. Eat a balanced diet and exercise where possible. Do what feels right for you. Seek advice from your oncologist and use the support that is available from the breast cancer charities.”

What's your hope for the future?

DM: "Many generations have had the fear of breast cancer hanging over them. I don't want that for future generations. I want that to be gone.

"I believe it will happen in my lifetime."

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