PracticeUpdate: Haematology & Oncology

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Breast cancer survival rates By Lillie Shockney RN, BS, MAS B reast cancer death rates among women decreased be- tween 2010 and 2014, although racial disparities con- tinue to be an issue according to a study by the Centers

LAUNCHING SOON The year’s top research, all in one issue Welcome to our special issue, PracticeUpdate Haema- tology&Oncology: Best of 2016 , featuring a collection of the best research of the year from some of the top oncology and haematology conferences. Our PracticeUpdate Oncology Advisory and Editorial Board members discuss their top oncology story of 2016 (see left), and share their take on the best studies and presentations from the ASCO, EHA, ESMO and HAA meetings. On behalf of the Elsevier Australia PracticeUpdate Haematology & Oncology team, I thank you for your continued support and readership. We’ve made some big changes this year, with a new masthead and improved content, in our continuing efforts to be relevant and integral to your day-to-day clinical practice. Happy holidays and I wish you well for 2017! Anne Neilson Managing editor, PracticeUpdate Haematology & Oncology (Australian Edition) rarehaematology.elsevierresource.com News, expert opinion, journal articles, conference coverage dedicated to rare haematological diseases Selected by editorial board members from the Journal of Molecular Genetics & Metabolism Rare Haematology RESOURCE CENTRE

for Disease Control and Prevention (CDC) in the US published recently in the Morbidity and Mortality Weekly Report ( Cancer Res Treat 2016;160:145-152). The report shows changes in death rates from breast cancer by age group for black and white women, the groups with the highest death rates in the United States. Lisa Richardson, MD, Director of the CDC’s Division of Cancer Prevention and Control, said, “First, the decline in deaths suggests that white and black women under 50 are benefitting equally from cancer treatments. Second, we’re hopeful the lack of difference in death rates between black and white women under 50 will start to be seen in older women.” It has been particularly devastating for families with young children to lose the young mother to metastatic breast cancer. We are making headway with improvement in treatment options and more personalised medicine based on specific prognostic factors and genomics, however, thus lowering the mortality rate and giving more time to young women diagnosed with stage IV disease to spend with their families. It is worthy to note that there was a greater decrease in breast cancer death rates among white women (1.9% per year) than black women (1.5% per year) between 2010 and 2014. The largest difference by race was among women aged 60 to 69 years, in whom breast cancer death rates dropped 2.0% per year among white women, compared with 1.0% per year among black women. “The good news is that overall rates of breast cancer are decreasing among black women. However, when compared with white women, the likelihood that a black woman will die after a breast cancer diagnosis is still considerably higher,” said Jacqueline Miller, MD, Medical Director of the CDC’s National Breast and Cervical Cancer Early Detection Program. The CDC’s research was further supported by the study, “Ten-year survival in women with primary stage IV breast cancer,” published in the November issue of Breast Cancer Research and Treatment ( MMWR Morb Mortal Wkly Rep 2016;65:1093-1098).The research study evaluated 25,323 women with stage IV breast cancer from 1990 to 2012 to determine how survival varies with age at diagnosis. Results showed decreasing survival with advancing age: for women aged 40 years and younger, the 10-year survival rate was 15.7%; for ages 41 to 50 years, it was 14.9%; and for women aged 51 to 70 years, it was 11.7% (P < 0.0001). The adjusted risk of death from breast cancer at 10 years was lower for women aged 40 years and younger (HR, 0.78) and women aged 41 to 50 years (HR, 0.82) compared with women 51 to 60 years old. In comparing age groups, as the CDC publication did, women with stage IV breast cancer have a 10-year survival rate of about 13%. Those women diagnosed with stage IV breast cancer up to the age of 50 years have a lower risk of death in 10 years compared with women over 50 years. Providers, including nurses, need to be vigilant in reminding women about breast cancer screening and teaching the warning signs of a breast health problem, no matter what type of patient encounter they are having with the woman, or what her age or race is. Take the time to assess each patient and determine if she falls into a high-risk population that may require closer monitoring than the average female population. This information about improvements in mortality provides hope for future young women tragically diagnosed with metastatic disease. Until there is true prevention and cure, survival remains the primary goal, along with preservation of quality of life.

The Rare Haematology Resource Centre has been funded by Sanofi Genzyme.

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DECEMBER 2016