Breakthrough experimental vaccines could finally eliminate one of the most common cancers in women and help America win the battle against cancer.
More than 264,000 women are diagnosed with breast cancer each year. It is the most common type of cancer in women in the United States. More than 43,000 women die from this disease annually.
But between 1989 and 2020, mortality rates fell by 43 percent, thanks to successful public health education campaigns, better screening, and new drugs.
The graph above shows the female breast cancer case rate per 100,000 people compared to the death rate represented by the red squares. As death rates have fallen, case numbers are still rising. The blue and green dots are from two different databases that track breast cancer rates over different time periods
The rate of new cases has remained fairly stable between 1992 and 2020, at around 130 per 100,000 women.
But the number of new breast cancer cases is increasing by about 2 percent each year, John Wong, an internist and professor of medicine at Tufts University School of Medicine, told The Washington Post.
Modern mammography methods were developed in the late 1960s and were first officially recommended by the American Cancer Society in 1976. They are still the most trusted breast cancer screening method.
The first mastectomy – a method of treating breast cancer in which the entire breast is surgically removed – was performed in 1882 by the American surgeon William Halstead. To date, this is the standard surgery for breast cancer.
According to the National Cancer Institute, a double mastectomy reduces the risk of developing breast cancer by at least 90 percent in women with a strong family history.
In 1937, radiation therapy and breast salvage surgery were introduced. After the tumor is removed, radium needles are inserted into the breast and near the lymph nodes.
In 1978, tamoxifen was approved by the Food and Drug Administration (FDA) for use in breast cancer treatment.
The graph above shows the changes in breast cancer screening (black line) since 2017 per month. It also shows a projected screening rate (yellow dotted line) and the Covid infection rate (blue line) in the US over the same period. The number of check-ups was initially stable, but fell by up to 14 percent in the first year of the pandemic
The anti-estrogen treatment was the first in a new class of drugs called SERMs – selective estrogen receptor modulators.
Eighteen years later, the FDA approved anastrozole (Arimidex) for the treatment of breast cancer. The drug blocks the production of estrogen.
Since then, numerous other drugs have been approved. One of the newer drugs, Trodelvy, received FDA approval in 2020. It treats triple-negative breast cancer that has spread to people who have failed at least two other treatments.
In May, a leading health panel recommended lowering the age at which women have regular breast cancer screening from 50 to 40.
The US Preventive Services Task Force (USPSTF) said every two years an additional 20 million women in their 40s would benefit from a mammogram.
According to the USPSTF, which drafted the proposal in response to rising rates among middle-aged women, the change would save 20 percent more lives.
Currently, all women aged 50 to 74 are recommended to have a mammogram — a low-energy X-ray of their breasts — checked every two years.
The advent of chemotherapy drugs in the 1970s boosted survival rates across the board. But it wasn’t until the generic versions of the drugs became available in the 1980s that access became more general.
Treatment options for breast cancer include surgery, chemotherapy, radiation therapy, and hormone treatment. A combination of two or more of these treatments is often used.
Radiation therapy uses high-energy beams of radiation that are focused on cancerous tissue.
This kills cancer cells or stops them from multiplying. It is mainly used as a supplement to the operation.
Depending on the size of the tumor, a patient may undergo breast-conserving surgery or removal of the affected breast.
Physicians have identified genetic mutations that put women at high risk of developing breast cancer.
Some of these women choose to have a voluntary prophylactic mastectomy – the surgical removal of both breasts, even if they are perfectly healthy at the time, to reduce the risk of breast cancer.
Angelina Jolie famously opened up about her decision to have a double mastectomy and reconstruction in 2013.
This led to the “Angelina Jolie” effect – an increase in genetic testing for breast cancer.
Chemotherapy, a cancer treatment with cancer drugs that kill cancer cells or stop them from multiplying, is often used.
Some types of breast cancer are influenced by the “female” hormone estrogen, which can stimulate cancer cells to divide and multiply.
Therapies that lower the levels of these hormones or prevent them from working are often used in breast cancer patients.
Now a new line of treatment is emerging – cancer vaccines to treat and prevent cancer.
A vaccine developed at the famous Mount Sinai Hospital in Manhattan, New York, quickly makes the primary tumor disappear and teaches the body to hunt down and kill cancer cells that have spread elsewhere.
Two women with breast cancer in a clinical trial experienced partial and complete remissions after receiving the vaccine, which is not for the faint of heart.
Over a period of six months, patients receive 17 injections into the tumor and another eight in the arm.
Meanwhile, a new triple-negative breast cancer vaccine developed jointly by Anixa Biosciences and the Cleveland Clinic is also raising hopes for a cancer-free future.
Unlike most cancer shots tested, which are given to patients after diagnosis, the new vaccine is given to cancer survivors to prevent it from coming back or to get well years in advance.
The vaccine has several key hurdles to overcome, including large-scale human testing and Food and Drug Administration approval, but Dr. Amit Kumar, CEO of Anixa Biosciences, the company developing the vaccine, told DailyMail.com that if they go well, “We may be able to eradicate breast cancer as a disease like we eradicated polio and smallpox.”
President Joe Biden declared his war on cancer in the United States last year and promised to halve the number of deaths from the disease within 25 years.
The National Institutes of Health recently declared this goal “impossible”.
Lung and breast cancer have seen the biggest improvements in falling death rates to date, thanks to successful awareness campaigns and healthier habits, experts say.
However, there are concerns that some of the gains made in the early stages of the pandemic were lost after many walked away from health services.
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