Breast Cancer Prognosis and Survival Rates
Breast Cancer Prognosis and Survival Rates:
- For women diagnosed with breast cancer in 2001-2006, five-year relative survival rates have reached 82% (England only) compared with only 52% thirty years earlier in 1971-75.
- Ten-year survival rates have increased from 41% for women diagnosed in 1971-1975 to 73% for 1996-2000.
- The predicted twenty-year survival for breast cancer patients diagnosed in 2001-2003 is 64%.
- Similar increases have occurred in Scotland. Breast cancer survival rates for Scottish women diagnosed in 2000-2004 are 94% at one-year, 78% at five years, and 65% at ten years.
By age at diagnosis
Breast cancer survival varies by age at diagnosis. For most cancers relative survival decreases with age but breast cancer is unusual in that women diagnosed in their 50s and 60s have consistently higher survival rates than either younger or older women. Over then ten year period 1991-93 v 2001-03, survival improved for all age-groups at all end-points but the younger women had smaller improvements than women aged over 50. For e.g., ten-year relative survival increased by 13% over this period for women aged 15-49 compared with 24% for women aged 50-69 and 18% for women aged 70 to 99.
By stage at diagnosis
The later the stage of the disease at diagnosis, the lower the survival rate. For women diagnosed in the early 1990s in the West Midlands, 5-year relative survival rates were 92% for stage I tumours, 73% for stage II tumours, 50% for stage III tumours and 13% for stage IV tumours. At ten years, the survival rates were around 5% lower for stage I and IV tumours, and around 10% lower for stage II and III tumours.
Analysis of breast cancer survival by level of deprivation has consistently shown higher survival for more affluent women. In England and Wales in the 1970s and early 1980s the deprivation gap in five year survival was around 10%, but fell to 6% in the late 1980s. Although not directly comparable because the deprivation measures are not identical, five year survival by deprivation in Scotland showed a similar difference in the late 1980s. The deprivation gap for both countries remained largely unchanged in the 1990s, despite the fact that more affluent women attended screening. For women diagnosed in 1987 or 1993 in Scotland, affluent women under 65 were more likely to have ER positive (good prognosis) breast cancers than their deprived counterparts (65% v 48%). This difference accounted for between 20-30% of the observed 10% survival gap between the affluent and deprived. Other factors which may contribute to the deprivation gap in survival include co-morbidity, stage at diagnosis, and access and uptake of treatments.
In Europe and Worldwide
Cancer survival in Europe has been calculated since 1978 by the EUROCARE program. Reports based on the latest data show that breast cancer survival has improved over time and inter-country survival differences are reducing. However, survival in the UK is far from the best and much lower than reported in the US.
Generally breast cancer survival rates are highest in northern Europe and lowest in Eastern Europe. Comparative survival rates are difficult to interpret as they are affected by a number of factors but more detailed studies have suggested that the lower breast cancer survival rates in the UK compared to other northern European countries are largely explained by patients having more advanced disease at diagnosis.
A study of cancer survival rates across the world has recently been published. Five-year relative survival rates, standardized to the International Cancer Survival Standard, were calculated for patients aged 15-99 diagnosed during 1990-94. Breast cancer survival rates varied from over 80% in North America, Sweden, Japan, Australia and Finland to less than 60% in Brazil and Slovakia and below 40% in Algeria. Most European countries including Scotland, England, Ireland and Wales, had rates in the 70-79% range. As with the deprivation gap, a variety of factors are likely to affect these outcomes.
Breast Cancer Survival rates
The prognosis for breast cancer generally depends on its stage and there are typically five stages (0 to 5) with sub-stages: