Breast Cancer Survival Rates: Prognosis and Risk Factors - Verywell Health

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The rate of survival among breast cancer patients has increased dramatically in recent decades. Between 1989 and 2017, the overall death rate from breast cancer declined by 40%. This is likely attributed to an improvement in screening and early detection, increased awareness of symptoms, and improvements in treatment options. Due to the decline in death rates, it is estimated 375,900 deaths were avoided in the United States between 1989 and 2017.

Data from the National Cancer Institute’s Surveillance, Epidemiology and End Results Program (SEER) shows that today, the 5-year survival rate for breast cancers across all stages is 90%.

There are a number of factors that can improve or worsen prognosis.

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Survival by Stage

Breast cancer staging is used to classify how far cancer has spread and how much cancer is in the body. This enables physicians to determine the severity of the cancer and decide appropriate treatment options.

The most commonly used staging system in breast cancer is the American Joint Committee on Cancer (AJCC) TNM System. Under this system, there are two different types of staging:

• Pathological staging: Done through the examination of tissue samples taken during surgery.
• Clinical staging: Determined through non-operative means like a physical exam, imaging, or biopsy.

Typically, breast cancer staging is determined using a scale between 0 and IV (4). Stage 0 refers to cancers like carcinoma in situ which are non-invasive and stay in their original location, whilst stage IV (4) refers to an invasive cancer that has spread. Using the TNM system, cancers are staged by taking into account seven pieces of information.

• T: Size of the tumor
• N: Spread to nearby lymph nodes
• M: Spread (or metastasis) to distant sites
• ER: Estrogen receptor status
• PR: Progesterone receptor status
• G: Cancer grade
• Her2: Her2 status

Another way to stage cancer is the SEER system of breast cancer staging, which groups cancers into three categories:

• Localized: Cancer remains in the breast and has not spread elsewhere in the body
• Regional: Cancer has spread from the breast area to nearby lymph nodes or structures
• Distant: Cancer has spread from the breast to other parts of the body like the liver or lungs

Generally speaking, the lower the number, the less the cancer has spread. A stage I (1) in the TNM system would equate to a localized cancer in the SEER system. Whilst a Stage IV (4) in the TNM system would equate to a distant classification in the SEER system.

Survival rates give an indication of what percentage of people with the same kind and stage of cancer will still be alive after a given period. This is typically measured as a five-year survival rate. This can give an indication of how successful treatment might be.

5-Year Survival Rates for Breast Cancer
Localized	99% five-year survival rate
Regional	86% five-year survival rate
Distant	27% five-year survival rate

All stages combined have a 90% five-year survival rate.

Recent data suggests survival rates for breast cancer are:

• 91% after five years
• 84% after 10 years
• 80% after 15 years

Survival by Age

Both the incidence and death rate of breast cancer increases with age until the age of 70. Between 2012 and 2016, the median age of breast cancer diagnosis was 62. In 10-year age groups, the likelihood of a diagnosis of breast cancer is highest for those aged in their 70s. Death from breast cancer is highest among those in their 80s.

Age can influence survival rates for breast cancer. The risk for invasive breast cancer is highest between the ages of 50 and 69. Just 18% of cases are diagnosed before the age of 50.

The age of a woman’s first period and the onset of menopause both influence breast cancer risk. Studies have found that the younger a woman is at her first period, the higher the risk of breast cancer later in life, and similarly the later the onset of menopause, the greater the risk of breast cancer. 

How Prevalent Is Breast Cancer?

Breast cancer accounts for around 15% of all cancers in the United States, resulting in over 276,000 new diagnoses and 42,000 deaths in 2020.

Survival by Race

Race influences both incidence and survival rates of breast cancer. In the United States, although non-Hispanic white women have a slightly higher chance of being diagnosed with breast cancer, black women are more likely to die from breast cancer.

Recent statistics suggest non-Hispanic back women had the highest death rate from breast cancer in any group, with 28.4 deaths per 100 thousand. At every age, black women are more likely to die from breast cancer.

It’s estimated that about 21% of breast cancer cases among non-Hispanic black women are triple-negative. The incidence of this form of breast cancer among black women is nearly double that found among other races and ethnic groups. This likely contributes to the higher death rate in black women.

Black women have a higher chance of developing aggressive forms of breast cancer and being diagnosed with advanced-stage cancers at a young age.

It is possible the higher death rate among black women is due to disparities in health care access. Less availability of mammography and poorer quality medical care may both contribute to poorer survival rates among black women. Lack of resources can have a significant impact on prognosis and outcomes for women with breast cancer.

Socioeconomic factors are also likely to play a role. In 2018, the poverty rate among black people in the United States was 18.8% compared with 7.3% among non-Hispanic whites.

Poor women are less likely to have as much access to information on early detection or screening options, less likely to have good health insurance, and less likely to access the best treatments.

Lifestyle factors may also play a role. Black women have a higher rate of obesity than other races and ethnic groups. Obesity has been linked to breast cancer risk.

Breast Cancer and Race Highlights

• Five-year survival rates in breast cancer improved from 76% in white women in 1975-1977 to 92% in 2009-2015.
• Among black women, the five-year survival improved from 62% in 1975-1977 to 83% in 2009-2015.
• Breast cancer is the most commonly diagnosed cancer among black women.
• Breast cancer accounts for the second-highest number of cancer deaths among black women.
• Inflammatory breast cancer, a rare but aggressive subtype of breast cancer is more common in black women.
• Breast cancer is the second most common cause of cancer death among black women after lung cancer.
• Breast cancer death rates are about 40% higher in black women than white women.
• 54% of breast cancers are diagnosed at local stage, compared to 64% in white women.

Other Factors That Influence Survival

There are many factors that influence the chance of survival with breast cancer. Some of these, like race, are non-modifiable, while others, like lifestyle factors, can be modified to improve outcomes.

Subtype

Breast cancer subtype can influence survival. Breast cancers are divided into four subtypes. Here is a closer look at those:

• Luminal A: 94.1% survival rate after five years
• Luminal B: 90.4% survival rate after five years
• Triple-Negative: 76.7% survival after five years
• HER2-enriched: 83.6% survival after five years

Tumor Size

Tumor size can influence survival rates. Tumors less than 5mm in size have a good prognosis with survival rates as high as 90 to 95%.

Lymph Nodes

The number of lymph nodes involved in breast cancer can increase the risk of death.

Gene Mutations

The impact of BRCA gene mutations on the risk of a diagnosis of breast cancer is well established. Those with this mutation are at an increased risk of breast cancer. But studies suggest such gene mutations may not influence survival rates. Patients with the BRAC1 or BRAC2 mutation have a similar prognosis as those without these mutations.

Diabetes

Diabetes has been associated with a poorer prognosis in breast cancer. Death rates in breast cancer are higher among those who have diabetes than those who don’t. Increased death rates in this group may be due to insulin resistance.

Smoking

Smoking has a significant impact on breast cancer survival. Studies have found those who were current smokers were at a 28% increased risk of death from breast cancer than those who never smoked. Those diagnosed with breast cancer can lower their risk of death from breast cancer considerably by ceasing smoking.

A Word From Verywell

Overall, breast cancer survival rates have been improving in recent decades. This is due to early detection, better screening, and improvement in treatment options. Breast cancer survival rates are dependent on a number of factors and vary greatly between each person. Survival rates may not necessarily be indicative of a person’s unique situation, as survival rates are based on outcomes for everyone within a population group, regardless of co-morbid conditions and other factors.

Some factors that increase the risk of death from breast cancer, like race, aren’t modifiable, but other factors, like ceasing smoking, can make a positive difference to outcomes and improve the chance of survival. If you are unsure what risk factors you could modify in your own life to improve chances of breast cancer survival, discuss this with your doctor.

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