番茄社区

Progress that led to improved survival in early breast cancer has yet to carry over to the advanced/metastatic setting. Neither 5-year nor overall survival has improved substantially over the past decade. The explanation for the lack of progress is multifactorial, as described in a .

In the first part of this exclusive two-part 番茄社区 video, Fatima Cardoso, MD, co-author of the report and director of the breast unit at the Champalimaud Clinical Center in Lisbon, Portugal, discusses the worldwide status of advanced/metastatic breast cancer and addresses some of the reasons for the lack of improvement in long-term survival.

Following is a transcript of her remarks:

Regarding advanced breast cancer, unfortunately, things have cannot changed as much as we would like and we would expect. Recently, so the end of last year, we have published a report -- it's called a decade report -- that looked into what happened in this field in the last 10 years. What we have seen is that, unfortunately, starting with the median overall survival, we have increased a mere few months in a decade period. If we look at the percentage of patients who are alive at 5 years, we only improve from 23% to 25%. Clearly, in terms of efficacy, we have not improved as much as we could and we should for these patients.

Another finding that was very shocking to me personally, from this report, is now we thought that we are now being able to improve survival, but for certain, we have improved quality of life. Well, unfortunately this is not true, at least according to this report. At least for the last decade, the quality of life has not improved, perhaps even decreased a little bit.

We still find a huge amount of a lack of knowledge -- both from the general population, the media, the politicians -- so they still do not differentiate metastatic disease from the early setting, and they still think of breast cancer as just one disease, one setting, which is clearly wrong. One in four or one in five people believe that patients with metastatic disease should not talk about it, should talk about it exclusively with their oncologist.

So, this taboo of talking about the disease -- that it's incurable, a disease that inevitably will lead to death -- still exists around the world, and this leads to extreme attitudes. Patients need different resources, even different support resources, different information resources, and we still don't have these dedicated resources in the large proportion of the world.

But if I would have to say where there have been more advances in this last decade, it is probably around the availability of advocacy efforts. A decade ago, there were almost no support groups and advocacy groups for metastatic patients. Now, the majority of the very large advocacy groups -- like EUROPA DONNA in Europe, Susan Komen in the U.S. -- they have dedicated resources for metastatic patients and they are dedicated groups for these patients. We've done an enormous amount of work and extraordinary work in this field.

Finally, in terms of policy policymakers and politicians, perhaps there is a glimpse of hope since the last European Parliament declaration, regarding breast cancer, has for the first time one of the bullet points dedicated to metastatic disease. Maybe there is a glimpse of hope that people will start understanding that this is different.

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