Breast cancer deaths plummet

Early detection has saved lives

An unprecedented fall in the number of breast cancer deaths is largely due to the use of the drug tamoxifen which was developed in Cardiff.

A combination of treatment advances has been credited with 25% drop in both the UK and US over the last decade.

It is the most sudden drop in mortality for a common cancer seen anywhere in the world.

And it reverses a 26% rise in mortality between the 1950s and 1987.

New treatments are far better at stopping the cancer recurring once the initial malignant breast lump has been removed by surgeons.

But doctors expressed concern that some women who could be helped by improved treatments are still not getting them.

Tamoxifen works well against some breast cancers

For example, the hormonal therapy tamoxifen, normally given straight after breast surgery, is still not given to many younger women despite evidence that it reduces the chance of recurrence.

Professor Richard Peto, from Oxford University, said: "Starting tamoxifen immediately after breast cancer surgery prevented one in six women from relapsing and one in twelve from dying, irrespective of age.

"But most of the young breast cancer patients who need tamoxifen aren't yet getting it."

Halves rate of return

A study of the drug suggested that starting it immediately after surgery, and continuing the treatment for at least five years, halved the recurrence rate.

Dr Michael Clarke, the study co-ordinator, said: "Tamoxifen is not expensive - in most countries, five years of treatment costs only a few hundred pounds - or, to put it another way, a few thousand pounds per life saved."

David Campbell-Morrison, director of the Campaign for Effective and Rational Treatment, said: "This report underlines what Cert has been consistently telling the government - that proper use of the right drugs, in the right patients at the right time can, and does, save lives.

"This has been achieved even with the older types of chemotherapy. Think what might be possible if the NHS put realistic resources into the newer proven drugs."

Two other pieces of research suggested both that radiotherapy, and improvements in chemotherapy were also saving lives.

In addition, the early detection of breast cancers by the national breast screening programme has undoubtedly had a positive impact.

'Good news'

Delyth Morgan, chief executive of the charity Breakthrough Breast Cancer, said: "This is good news for women. Any reduction in the numbers dying from breast cancer is to be welcomed.

"It is still not clear exactly what the causes of the reduction are, but they could be due to a variety of factors including the introduction of chemotherapy, new drug treatments, better surgeons, earlier detection, better diet or a host of other influences."

She said tamoxifen had been a major advance, but added that women should be aware of the risks of taking the drug as well as the benefits.

Some breast cancers respond to the female sex hormone oestrogen, and the drug works by blocking the hormone receptors on cancer cells, stopping them growing.

Doctors often test to see if the cancer is hormone-sensitive before deciding whether to give tamoxifen.

However, it does slightly increase the risk of uterine (endometrial) cancer, or a blood clot on the lungs, and can cause menopausal symptoms in some women.

The research is detailed in the Lancet medical journal.