Early Detection is Not a Cure

This is a surprise to many people.  Screening and early detection of breast cancer has been emphasized and elevated to such a level in our country that most women feel that screening and early detection IS the cure for breast cancer.

Unfortunately, it’s just not true.  Biology is just as important as the size and stage of the breast cancer.  Some breast cancers behave more aggressively, right from the start, even when found quite early.  Others, even when found early, linger in the body somehow to rear their head again many years later.

Detecting cancer as early as possible, and beginning appropriate treatments is the best we can do for now, but we need more.  We urgently need to understand how and why some cancers spread to other parts of the body (either early on or later), and we need more treatments to target those more aggressive cancers.

A study published this month on early, Stage I breast cancers in over 1000 women, showed that those with triple-negative disease (estrogen/progesterone receptor negative and her-2/neu negative) had over six times the risk of recurrence in the first five years than women with hormone receptor positive disease.  The differences in recurrence were found for tumor sizes between 0.5 cm and 2 cm.  Five-year relapse free survival was 89% for those with triple-negative disease, compared to 98% for the hormone receptor positive group.

This was in spite of the much more aggressive treatment received by the women with triple negative disease.  The authors of the study, published in the September/October issue of The Breast Journal, conclude that even aggressive chemotherapy treatment does not level the field for patients with early stage triple negative disease, and that new, more effective treatments are urgently needed.

Early detection of breast cancer is important, but it is not the cure.  Let’s not get distracted from the work that needs to be done.

“T1N0 Triple Negative Breast Cancer: Risk of Recurrence and Adjuvant Chemotherapy”
Henry G. Kaplan, MD, Judith A. Malmgren, PhD  , and Mary Atwood

Breast J 2009;15:451-460

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  • Marjorie  On September 10, 2009 at 10:29 pm

    Thank you Laura! You’ve nailed this issue at the right time of year – when the annual pink hoopla starts and the myth making machine concerning this dreaded disease continues to be funded.

    Let’s tell the truth and keep telling it until real progress is made. Let’s get recurrence data reported into the SEER and state cancer registries. Incidence and mortality data are only part of the picture.

  • suzanne  On September 11, 2009 at 11:18 am

    thanks, laura, for so cleanly and concisely outlining the reasons for concern among those of us who have been screened, diagnosed with cancer, and then faced triple-negative disease. it is critical that those interested in ELIMINATING breast cancer know that stage and size don’t tell the whole story, and many of us are little safer following treatment. it might be useful if one of your pieces could be on second primary tumors, which i understand can sometimes a hormonal/her2 status different from the first.


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