Research Shows Dramatic Reduction in Breast Cancer Mortality

Improvements in early detection and the refinement of treatment concepts have resulted in the rate of mortality from breast cancer dropping by one third over the last 30 years, claims a new review.

According to researchers at the Medical University of Vienna and Vienna General Hospital, breast cancer treatment has progressed substantially over the years with concomitant reduction in therapy intensity, with the aim of avoiding both over- and under-treatment becoming a major focus of new therapy concepts. New treatments tend to follow a curative intent, and need to be decided in a multidisciplinary setting, taking molecular subtype and locoregional tumor load into account.

Primary conventional surgery is thus not the optimal choice for all patients, and in triple-negative and hormone receptor (HER2)-negative early breast cancer, neoadjuvant therapy has become a commonly used option. Depending on clinical tumor subtype, the therapeutic backbones of treatment now include endocrine therapy, anti-HER2 targeting, and chemotherapy. In metastatic breast cancer, therapy goals of newer targeted therapies are prolongation of survival and maintaining quality of life, using endocrine therapies HER2 for long-term disease control. The review was presented at the 15th St. Gallen Breast Cancer Conference, held during March 2017 in Vienna (Austria).

“Nowadays, we believe that successful treatment is only possible by taking a more interdisciplinary approach. We are able to provide this at the comprehensive cancer center of MedUni Vienna and Vienna General Hospital because we have combined all the disciplines under one roof,” said review presenter Michael Gnant, MD, head of the department of surgery at MedUni Vienna and AKH. “These include fundamental cancer research, the specialist areas involved, and clinical research, and this enables us to keep our finger on the pulse of medical progress.”

“Overtreatment often has huge side-effects for patients without providing any therapeutic benefit. We are therefore going to discuss the question with international experts and thrash out the optimum strategy for treating ductal carcinoma in situ,” said conference chairman Farid Moinfar, MD, of the Medical University of Graz (Austria). “The long-term aim is to make a more accurate distinction between ductal carcinoma in situ cases and divide them into biological subtypes, so that we are able to filter out those that do not require any further treatment following surgery.”

Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer, in which the abnormal cells are contained inside the milk ducts. If DCIS is not treated, it may eventually develop into invasive breast cancer, which can spread outside the ducts into the breast tissue and then possibly to other parts of the body. Since DCIS cannot usually be felt as a breast lump or other breast change, most cases are diagnosed following routine screening with mammograms or ultrasound, appearing as micro-calcifications.