Breast cancer deaths plummet welcomed

Early detection has saved lives

A leading Northern Ireland breast cancer specialist has welcomed new research which shows the number of women dying from the disease has dropped dramatically.

Figures published in The Lancet medical journal show that death rates have fallen significantly in the past decade due in part to the drug tamoxifen.

However, William Odling-Smee, director of the breast service unit at the City Hospital in Belfast, said the rate of decrease is slower in Northern Ireland than in the rest of the UK.

Mr Odling-Smee said: "Our rate is falling and it has fallen very significantly since 1989.

"But the graph is not quite as steep as it is in the whole of the UK."

According to the Lancet, the drug, tamoxifen, developed in the UK, appears mainly responsible for almost a 30% drop in deaths in the UK over the last decade.

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

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

But doctors have expressed concern that some women who could be helped by improved treatments were 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 the Imperial Cancer Research Fund, 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."

Two other pieces of research suggested that both 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."

Other cancers have not seen such a dramatic drop in mortality figures.

Professor Jonathan Waxman said there had been enormous increases in prostate cancer over the last 30 years, with deaths rising from 3,300 in 1964 to 8,600 in 1998.

Despite the increase, only £800,000 has been spent on research in the past three years, compared with £5m a year for breast cancer, he told BBC Radio 4's Today programme