First, for some good news. There has been, and continues to be, a decline in the breast cancer death rate. It’s been on a downward trend since 1989. This means were doing a better job at screening and, that the word is getting out to women so that there is an increasing awareness of the symptoms. Quebec and other provinces have well run breast cancer screening programs. Thousands of breast cancer deaths have been averted. But there is still a lot to be done.

Breast cancer is the most common cancer (not including skin cancers) diagnosed among women. It’s the second leading cause of cancer death (after lung cancer) among women.

The numbers tell a somber tale. In 2019 in Canada it’s estimated that:

  • 26,900 women will be diagnosed with breast cancer (25 per cent of all new cancer cases in women);
  • 5,000 women will die from breast cancer (13 per cent of all cancer deaths in women);
  • On average, 74 Canadian women will be diagnosed with breast cancer every day.
  • On average, 14 Canadian women will die from breast cancer every day.
  • 230 men will be diagnosed with breast cancer and 55 will die from breast cancer.

Research continues to discover the different underlying causes. Obesity and alcohol have come onto the radar as risk factors. We now know more about the genetic risk factors (including the BRCA1 and 2 genes among others). We have new targets for treatment and new drugs to use. But these gains have not been shared equally. Not everyone has access to screening and the best care and so there’s much more work to be done to ensure that all women have access to quality care to help eliminate disparities and further reduce breast cancer death rates.

With all of our successes, there are increasing numbers of men and women living with metastatic breast cancer (disease which has spread beyond where it was first found). Doctors still do not know why some breast cancers spread. Eventually, nearly all patients with breast-cancer metastases run out of options and die, although in recent years, many have been living longer.

One of the most promising research projects looking at this is at the University of Utah’s Huntsman Cancer Institute. In this research, scientists are comparing breast cancer cells from a patient’s original tumor to cancer cells found elsewhere in the body after the disease has spread. Are there differences between these two groups of cancer cells to explain why some migrated?

And so, while much has been achieved, much still remains to be done. Each of us can play a role:

  • by supporting those who have been diagnosed;
  • reaching out and getting people to be screened; and,
  • making certain that our research and treatment facilities have the support that they need.

One of the most important lessons that the work on breast cancer has provided, is that each of us can make a difference.

Dr. Mitch Shulman is an Assistant Professor, Dept. of Surgery, McGill Medical School and an Attending Physician, Emergency Department, McGill University Health Centre. He’s also the CJAD AM 800 Medical Consultant.

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