NEW YORK, Oct. 23, 2019 /PRNewswire/ -- A retrospective analysis – reported in the journal Cancer by Judith Malmgren, PhD, and co-authors – studied patients in the Surveillance, Epidemiology, and End Results (SEER) 9 population and an institutional cohort with de novo metastatic breast cancer (MBC), which is a first diagnosis of breast cancer that is stage IV. The SEER 9 population includes cancer patients in nine US regions including Seattle-Puget Sound, and is representative of the US population. The institutional cohort includes patients with breast cancer who are followed over time, who live in the Seattle-Puget Sound registry area, and whose cases are included in SEER Seattle-Puget Sound. Approximately 13,000 new cases of de novo MBC are diagnosed annually in the United States.
Five-year breast cancer survival improved over time (1999-2011) to 26% in SEER 9 without Seattle-Puget Sound, to 35% in SEER Seattle-Puget Sound only, and to 56% for the institutional cohort. Thus, survival differed significantly by region.
Survival improved at the same time as new treatments were introduced.
Judith Malmgren, PhD, the study's lead author stated, "It's time for a more intelligent, evidence-based approach to de novo MBC treatment. Access to appropriate care may have the potential to extend life. Physicians may want to view their de novo MBC patients differently, and ask how long a patient's life can be extended. Work to identify specific patient and treatment factors associated with better survival is ongoing."
Study author, Henry Kaplan, MD, stated, "It is important to study patients who have metastatic disease at the time of diagnosis (de novo MBC) separately from those who initially are diagnosed with localized disease (recurrent MBC). The survival results described in this paper for patients with de novo disease are superior to those we have seen in recurrent MBC. This may be important in tailoring treatment to one type of metastatic disease versus the other. Studies are needed to examine the biology of these two types of MBC."
Study author, Musa Mayer, stated, "High-quality, innovative cancer treatments and supportive care extend life for those with an initial diagnosis of MBC, who now represent half of the 155,000 US patients living with MBC. But not all patients benefit. While this study offers hope for longer survival, it also documents worsening disparities with regard to access, adherence, and socioeconomic status."
More aggressive, receptor subtype-appropriate care, may play a role in improved survival. Survival disparities may be partly due to socioeconomic differences by region. Broadening access to appropriate, timely, and up-to-date care could potentially improve survival across all geographic populations and lead to a de novo MBC diagnosis becoming one with hope of life extension if not one of cure.
Shirley Mertz, Chair of the Metastatic Breast Cancer Alliance (MBCA), stated, "Breast cancer organizations and advocates within the MBCA must continue their efforts to ensure that newly diagnosed MBC patients, no matter where they live in the US or what their socioeconomic background is, are knowledgeable about their cancer subtype and have affordable access to the newest treatments for their disease."
Full citation: Malmgren JA, Calip GS, Atwood MK, Mayer M, and Kaplan HG. Metastatic Breast Cancer Survival Improvement Restricted by Regional Disparity: Surveillance, Epidemiology, and End Results and Institutional Analysis: 1990 to 2011. Cancer. 2019; https://doi.org/10.1002/cncr.32531.
The study was supported by the Kaplan Cancer Research Fund, the MBCA, and the SEER Cancer Surveillance System (CSS) program of the National Cancer Institute.