#BreastCancerAwarenessMonth: Landscape of Breast Cancer in Wales

At Cancer Research Wales, we are acutely aware of the impact of breast cancer. While we have come a long way and survival is better than ever, too many people still lose their lives to breast cancer each year. It is our conviction that research will be the driver of further improvements in survival rates and with the help of our supporters, we can put Wales at the forefront of innovations in diagnosis and treatment.

Cases

It is estimated that approximately 1 in 7 women will be diagnosed with breast cancer in their lifetime – this equates to almost 3,000 cases annually in Wales, which is an increase of around 20% in the last two decades.

It should not be forgotten that men can also be affected by breast cancer, with between 15-20 cases detected each year in Wales.

Importantly, breast cancer is often diagnosed at earlier stages, when it is easier to treat. In fact, over 70% of patients are now diagnosed with Stage I or II disease and only around 6% with Stage IV. This goes to show the likely effectiveness of both screening programmes and awareness campaigns, helping to tip the scales towards earlier diagnosis.

Interestingly, the incidence of breast cancer among different socioeconomic groups follows a different pattern to many other cancer types. People from the most deprived parts of Wales actually have a 20% lower rate of breast cancer compared to the most affluent areas, the reverse of the trend observed for most other cancers. The reasons for this remain unclear.

Survival

Thanks in no small part to research, breast cancer survival rates have improved dramatically over the last 50 years. In fact, today around 90% of patients survive for five years or more, compared to only 40% in the 1970s.

A major part of these improvements has been driven by early diagnosis, which is hugely important for breast cancer survival. 5-year survival for early-stage breast cancers is excellent, with 100% of Stage I and over 95% of Stage II patients still alive five years post-diagnosis. In contrast, less than a quarter of Stage IV patients survive five years or more, which emphasises just how important detecting breast cancer is for patient prognosis.

Unlike for incidence, breast cancer survival follows the pattern seen for many other cancer types with regards to deprivation. Those patients from the most deprived parts of Wales have 10% worse survival after 5 years compared to those from the most affluent areas (84 vs. 94%). The reasons for this are complex and variable, but this is clearly an unacceptable situation that requires addressing as a matter of priority.

Screening

Without doubt routine breast cancer screening has contributed significantly to the huge improvement seen in survival rates over the last few decades. By undertaking regular mammograms, tumours can be found at an earlier stage when they are easier to remove and treat. Studies have estimated that breast screening in Wales has reduced mortality from breast cancer by around 25%, saving many hundreds of lives in the process.

In Wales, women between the ages of 50 and 70 are invited to attend a screening appointment once every 3 years by Breast Test Wales. Women over the age of 70 can still take part in breast screening, but they but must contact Breast Test Wales directly to make the appointment.

Prevention

A large number (potentially around 30%) of breast cancers are considered preventable. Research has shown that breast cancer is a much more preventable disease than first thought and simple alterations to some lifestyle choices can significantly reduce the risk.

About 1 in 10 cases of breast cancer can be attributed to alcohol, so limiting its consumption is a straightforward way to decrease the risk. Maintaining a normal weight and eating a healthy diet can also reduce the risk of breast cancer, as obesity has been shown to be responsible for around 2–3 cases per 100 of breast cancer.

As with many cancer types, a generally healthy lifestyle that includes exercise and a varied, nutritious diet will help to minimise the risk of developing breast cancer.

In summary, breast cancer remains one of the most common cancers in Wales but has a significantly more favourable prognosis today than in the past. More patients than ever are surviving long term, keeping families together. However, there are still too many patients who lose their lives each year, particularly those with late stage or the most aggressive forms of breast cancer, so we still have work to do.

Keep an eye out for our next blog, where we will explore some of the research projects that Cancer Research Wales is currently funding, aiming to provide new treatment options for patients and to further improve survival rates.