Risk of dying from early invasive breast cancer down by around two-thirds in the last 20 years

Today, more than 90% of women diagnosed with early-stage invasive breast cancer will survive the disease for 5 years or more.

That wouldn’t be the case without research; or the people who make research possible.

Between 1993 and 2015, more than half a million women in England were diagnosed with early invasive breast cancer. Not only did they face something life-changing, they also showed us how much things have changed.

Here’s how. Patients can choose to share their NHS health data, which researchers can apply to use to track trends over time. 512,447 women contributed their information to a groundbreaking study we funded into breast cancer mortality in England since the early 1990s.

This is what the data showed us: women in England diagnosed with early invasive breast cancer today are around two-thirds less likely to die from the disease within the first 5 years than they were 20 years ago.

“The prognosis for patients with breast cancer has improved,” says oncologist and senior author Dr David Dodwell, from the University of Oxford’s Department of Population Health. “And that improvement is dramatic.”

Let’s put it another way. In the 1990s, 3 in every 20 women diagnosed with early invasive breast cancer would die from the disease within 5 years. Now it’s 1 in 20.

“Our general feeling that things are getting better has been confirmed,” continues Dodwell. “And not only that: we can probably be more optimistic than we had dared to hope.”

We can use that optimism now as much as ever. Things can still get better, which means there’s more to do.

Connecting doctors and patients

This is the first study of its size to follow up patients for an extended period, and to map out how detailed characteristics of specific patients and their cancers relate to different outcomes. That means it does much more than tell us about the past. 

“Our study can be used to estimate risk for individual women in the clinic today,” explains Professor Carolyn Taylor, lead author of the study.  

“It gives doctors the data they need to make predictions, or prognoses, for women diagnosed with early breast cancer. These prognoses can help women understand their situation and plan their futures.” 

The power of prognosis

Doctors told Mairead Mackenzie she had breast cancer in 2002. Hilary Stobart received the same news in 2009. 

They’re just two of the women who contributed their data to the study. In the years since, they’ve become passionate patient advocates and leading members of the charity Independent Cancer Patients’ Voice. They didn’t just feature in this research: they helped shape it, making sure the researchers focused on the questions that matter most to people with breast cancer. 

At the time of their diagnoses, though, neither knew how to react. 

“Whenever you get a cancer diagnosis, it’s a terrifying moment in your life,” says Mairead. “Initially, everybody thinks they’re going to die next week, but studies like this one can give reassurance to patients about their life ahead. And now, women with breast cancer have a much better chance of surviving.” 

Learning over the long term

But the experience of having cancer can’t be reduced to a 5-year prognosis.  

With most people surviving early invasive breast cancer for longer than 5 years, it’s important to think beyond the length of typical clinical trials. 

“You don’t have much grasp of having cancer until you’ve had it,” explains Hilary. “You suddenly join a club that you don’t want to be part of, and you find you have an awful lot in common with the other people in the club. You have a different perspective on what’s important.” 

Hilary and Mairead brought that perspective to the study.  

“I didn’t think what would happen to me in the long term was at all important beforehand,” Hilary continues. “I just wanted to know whether I was going to get treated and be okay and here next year. But 10 to 15 years on, it does matter to me.” 

“The truth is, in clinical trials, it’s almost impossible to get data beyond 10 years,” explains Dodwell. “With this kind of work, it’s easier. What happened to patients diagnosed 20 years ago isn’t what will be happening now, but these messages are enormously informative. And they might be the only way for us to realistically understand the long-term outcomes after breast cancer.” 

The past and future of breast cancer research

That’s not the only area where we need to keep up the pressure on breast cancer. This study shows that 6 in 10 women diagnosed today have a risk of dying from breast cancer within 5 years of 3% or less, but there are still groups of women who face much higher risks. 

Taylor and Dodwell’s study can be used to identify these women and give them the best available treatments as quickly as possible. It can also help focus future research on their specific needs. 

We’re here to keep driving that research. And we don’t do it alone. We’re beating breast cancer because of the hard work and generosity of people like Hilary and Mairead. 

“I’m yet to meet a cancer patient who isn’t happy for their data to be used for this sort of purpose,” says Mairead. “If there’s a chance of doing something that might make it easier for those coming after, breast cancer patients, like all cancer patients, say yes.”   

“And,” adds Hilary, “if they hadn’t said yes, we wouldn’t be where we are now.” 

The people who make this possible

“We know our treatment now is good because of all the work that was done earlier,” Hilary continues. “That was the first thing that got me into patient advocacy.  

“I used to work as a hospital physicist, dealing with people with breast cancer. So I knew what it was like in the late 1970s. That was my first thought when I was diagnosed, but I quickly saw how things had changed.  

“I mean, I didn’t have to have chemotherapy. If it was 10 years earlier, I probably would have been given it.  

“Then I began to realise why. It was due to all the trials, and the thousands of women who were prepared to go into them.” 

Those women have left an incredible legacy. These results make that clear. 

Now we can see the improvements decades of research have made possible, and we understand how we can keep making them in the years to come. 

“It’s good news,” concludes Hilary. “It shows what we’ve done, and that we need to go on doing it. More studies like this one will be needed in the future. Breast cancer is still with us. There’s a lot more work ahead.” 

Tim

This article was updated after being reviewed by our stats team on 26/09/2023.