Incredible hopeful study published in BMJ today
Comments
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TLDR:
The reasons this study cheered me immensely are as follows:
- there is an across-the-board and dramatic reduction in mortality rates from breast cancer compared with 30 years ago, regardless of stage/type of cancer.
- HER +ve cancer is now a positive prognostic indicator as herceptin so effective - a big change from how this type was perceived in the 1990s when it was seriously bad news.
- the improvement in survival is not thought to be 'stage capture' - ie. just down to early detection. So if (like me) you were not caught early, there is still cause for much hope. Comparing an identical version of myself in the 1990s with the actual version diagnosed in 2021, my prognosis is still markedly better. I thought I had lost any of the advantages of modern medicine as my tumours did not show up on scans and were large and node positive by the time they were discovered. But it seems that modern tumours themselves are more responsive to all the treatments we now have. It is not understood why this is the case (exercise, healthier lifestyles, different lifetime hormonal exposure would be my guesses) but breast cancer is an inherently more treatable disease than it was. So this is good news for everyone. (And obviously there are more treatments available too improving outcomes).
- small, oestrogen positive, low/med grade, node negative tumours in post menopausal women only increase your 5 year mortality very slightly above baseline - so if you are in this category then it is very reasonable to put the episode fully behind you and go back to normal.
While we would all still love to hear the word cure and have a test to prove it, for me this study is the next best thing. My formative experiences about breast cancer were from the 1990s (Linda McCartney, Caron Keating) when I was growing up and the outcomes seemed terrible. So the timing of this data has really had an impact for me. That said the 'real life' people I know who were diagnosed in the 1990s have all been fine (apart from one 😪). This study reflects that anecdotal observation.
I am so glad they made it an open access paper and hope it has brought encouragement to anyone going through the long dark road of diagnosis and active treatment.4 -
Oh and the other positive piece of information was that for every type of breast cancer, the risk of recurrence fell with time. This included oestrogen positive disease.
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Thank you so much for sharing this with all the helpful commentary <3 It does seem like good news!
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This study should make everyone with an HER2+ tumor feel really good. To take a negative prognostic factor and turn it into the breast cancer with the best prognosis is huge. And if I remember correctly it's a 66% precent reduction in all breast cancer deaths in the first five years than just 20 years ago. Obviously some people fare better than others in that reduction but it does show how far treatment has come. As far as me, I've been reluctant to believe my positive prognosis because of a grade 3, T2 lump. I'm under 10% for 10 years but still feel like I'm walking the proverbial plank. Seeing the results quantified like this though makes me more likely to believe that my oncotype percentage score is correct. It's a good feeling. No guarantee for anyone of course but treatment itself has come a long way.
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