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Huge Leap In Breast Cancer Survival Rate

A medical staff member examines a mammogram image.

Mammograms can be used to diagnose breast cancer.Credit: Michael Hanschke/DPA Picture Alliance/Avalon

The number of people who die after a breast cancer diagnosis has decreased by two-thirds since the 1990s, a study of more than half a million women in England has shown.

The research has taken ten years to complete, says Carolyn Taylor, lead author of the study and an oncologist at the University of Oxford, UK. The analysis includes the 512,447 women in England who were diagnosed with early invasive breast cancer between January 1993 and December 2015; the researchers tracked the women until December 2020 using data from the National Cancer Registration and Analysis Service.

Women who were diagnosed in 1993–99 had a 14.4% risk of dying within 5 years. This fell to 4.9% for women diagnosed in 2010–15 (see 'Improved odds'). The results were published1 on 13 June in The BMJ.

"We knew that mortality had reduced during the past 20 years, but we didn't know by how much," says Taylor. "That's a two-thirds reduction."

Improved odds.Line chart showing how breast cancer mortality rates improved over the years.

Source: Ref. 1

The study showed that the risk of death decreased across almost all age groups, and for both women whose cancer was diagnosed through screening, and those who had not been screened.

The reasons for the drop aren't clear, however. Since the 1990s, awareness of breast cancer has risen and, in England, routine screening is offered to more women. Randomized trials have explored how specific treatments affect survival after diagnosis. "What we can't do is say how much of the improvement is due to treatment or screening or breast cancer awareness," Taylor says.

The decline in mortality rate wasn't a surprise, says Naser Turabi, director of evidence and implementation at Cancer Research UK (CRUK) in London. CRUK funded the research, but Turabi was not involved in the study. "Research is incredibly important to determine the success of treatments," he says, and this study will help people to make better-informed decisions about their treatment.

Patient involvement was important to the study, Taylor says. The scientists appointed two patient representatives to guide their research. "They helped us in the questions to be addressed. They looked at the analyses and gave comments and suggestions throughout the study. And they helped us to interpret the results in the way that patients can understand."

Large-scale studies such as this one that track outcomes over many years are important for setting research and funding priorities, says Turabi. "Fundamentally, if we can't track the success of the interventions we put in place, the case for those interventions is weakened."

Mom, 37, With Stage 3 Breast Cancer Says Trying On Her Swimsuit Saved Her Life

As Julie Devaney Hogan put on her bikini over Labor Day weekend 2022, she felt a "barely there bump" below her nipple. Worried, she called her primary care doctor.

"I was told it was nothing to worry about," Devaney Hogan, 38, of Boston, tells TODAY.Com. "They said, 'Yeah, I wouldn't worry about it. You're scheduled for your physical at the end of October, just come in then.'"

After noticing a lump in her breast below her nipple while putting on her bikini, Julie Devaney Hogan visited her doctor and eventually learned she had stage 3 breast cancer. She started Season for Squeezin' to encourage others to check out their breasts when wearing their swimwear.Courtesy Julie Devaney Hogan

Still, she scheduled an appointment with her OB-GYN and underwent tests, which revealed why she had a bump: It was stage 3 HER2 positive invasive ductal carcinoma breast cancer.

"My bikini saved my life," she says.

Lump leads to diagnosis

After finding the "pea-sized" lump and being told by her doctor's office it was nothing to worry about, Devaney Hogan says she talked to her friends about it. One spoke up.

"My really good friend who's a nurse said, 'Absolutely not. Don't settle for not being seen,'" Devaney Hogan recalls. "She's like, 'I don't care what the doctor said. I don't care if they're not worried. Just get this checked. You have three babies — you need to be OK.'"

She called her OB-GYN in the hope she could be examined soon.

"Through a fair amount of pushing and persistence, I was able to get an appointment the following week," she says. "I probably could have pushed it off and been like, 'I'm busy, I've got stuff going on,' and I'm very grateful that I did it."

Her doctor referred her to a breast cancer facility, and she was again reassured that there was "nothing to worry about." She was told she could get a mammogram and biopsy, but she felt "there was zero urgency" in their recommendations. Still, she scheduled the tests.

"That bump was something. That bump was stage 3 HER2 positive and invasive breast cancer that had spread to my lymph nodes," Devaney Hogan says. "I very well could have brushed it off and waited. And I was told had I waited, we'd be in a very different scenario."

Julie cutting a boob cake for her "boob voyage" party

Julie Devaney Hogan cutting a boob cake for her "boob voyage" party before her double mastectomy.Courtesy Julie Devaney Hogan

She underwent 12 rounds of chemotherapy, a double mastectomy, lymph node removal and radiation to treat her cancer. Recent scans found some residual cancer, so she started chemotherapy again, which will last until next year, and she will undergo reconstructive surgery in November.

When she was 35, Devaney Hogan actually had a mammogram because of recurrent mastitis in one breast. That made the diagnosis even more surprising.

"There were no other symptoms," she says. "I did not present in any way or have a family history or other symptoms that would put me at high alert."

Navigating motherhood, her career as a vice president at a tech company and cancer has felt tough at times.

"Cancer can somewhat be glamorized and dramatized on TV, so you have this expectation of what it's going to be, and suddenly I'm going to transition from a busy mother with a career to a very sick person," Devaney Hogan says. "The reality is you get the diagnosis and then you come home, and your kids are still yelling at you for not opening their string cheese the right way."

She took a leave of absence from work to focus on treatment and recovery.

"I really started to think of this as the new job in my life," she says. "I was going to be dedicating hours a week to ... Ensuring I got though this."

As she went through treatment, though, she pondered her diagnosis.

"You never expect it to be you. Maybe that's an awful thing to say," she says. "I feel great, and I exercise and eat well, and it's shocking."

Julie Devaney Hogan hopes that Season for Squeezin' tags in swimsuits will encourage people to assess their breasts, even for those too young for mammograms.Courtesy Julie Devaney Hogan

She also felt like she knew her body well and wondered how she missed the lump.

"How was I so blindsided by the fact that this disease could get me," Devaney Hogan says. "That's where I started brewing this idea of squeezing and thinking about ways I could help ensure other women didn't have to think about breast cancer awareness only as a performative act ... In October."

Season for Squeezin'

Prior to her diagnosis, Devaney Hogan thought about breast cancer awareness in October as an event that meant she needed to find pink clothes for her children to wear to school or raising awareness of an illness that impacted older women. She wondered if there was something she could do that could make breast cancer prevention more relevant to women under the recommended age for a mammogram. Season for Squeezin' was born.

"Unfortunately, breast cancer is impacting a growing number of younger women," she says. "Why not meet them and the place they are in the summer and focus on the things they can do really tangibly?"

Devaney Hogan reached out to swimsuit makers, asking to include tags with information about breast cancer detection and the Season for Squeezin' campaign. Heidi Fish — known for designing one of the bikinis Padma Lakshmi wore in Sports Illustrated — agreed to include the tags. Devaney Hogan recently learned that Imsy Swimwear and Kortni Jeane Swimwear will also use the tags.

Most medical groups no longer recommend routine self-breast exams as a way to screen for breast cancer because research hasn't found that they improve breast cancer detection or survival rates, according to Mayo Clinic. However, it is recommended to be familiar with your breasts so you can recognize changes and what's normal versus what's not — and take this information to a health care provider as soon as possible.

"We were founded to drive the message of giving yourself a squeeze each time you suit up in your swimwear," she says.

She's launching a campaign the week of June 18 to encourage people to take pictures of themselves in their swimsuits holding fruit and tag five of their friends to do the same — she hopes it reminds people to familiarize themselves with their breasts.

Since her diagnosis and starting Season for Squeezin', Devaney Hogan has learned a lot about herself. Throughout her career in the tech industry, others have told her to "tone it down" or be "demure" if she wanted to succeed. But she found that staying true to herself has made a huge difference.

"Being myself has saved my life. I was comfortable pushing for what I needed, speaking up and (leaning) into my ability to build relationships," she says. "It's terrible it takes a diagnosis like breast cancer to accept and celebrate who you are."