More breast cancers are being detected later in women, giving the tumors a chance to spread and become life-threatening, a new study finds.

This increase in late-stage breast cancer affects women at all ages and ethnicities, according to results published Dec. 10 in the journal Radiology.

“Women with this diagnosis have a much lower survival rate and are much harder to treat,” said researcher Dr. Debra Monticciolo, a past president of the American College of Radiology.

Analysis of cancer registry data in the United States revealed that stage 4 breast cancer rates had increased:

• 2.9% annually for women ages 20 to 39 between 2004 and 2021

• 2.1% annually for women ages 40 to 74 between 2004 and 2012, and 2.7% between 2018 and 2021

• 1.4% annually for women aged 75 and older between 2004 and 2021

The five-year survival rate for women with stage 4 breast cancer is 31%, compared with 99% for early-stage cancer, researchers said.

“The significant increase in metastatic disease at diagnosis among all U.S. women and across all age groups is an alarming new finding,” said lead researcher Edward Hendrick, a clinical professor of radiology at the University of Colorado Anschutz School of Medicine. 

And the problem might be even worse than what’s reflected in these findings, Hendrick noted in a journal news release.

During the pandemic, the amount of mammograms conducted for breast cancer screening declined sharply, which means there was “likely undercounting of advanced disease in 2020,” Hendrick said.

“During the pandemic, we saw steep drops in the number of older, minority women being screened,” Monticciolo said. “This population tends to get left behind when any stress occurs in the health care system.”

Native American women had the largest increase in detection of advanced breast cancer, with an annual increase of 3.9% between 2004 and 2021, while the rate among Asian women increased by 2.9% annually.

Black and Hispanic women saw annual increases of 0.86% and 1.6% from 2004 to 2021, respectively.

The rate among white women increased 1.7% annually from 2004 to 2012, with no increase after that.

Overall, the rate of advanced breast cancer in Black women was 55% higher than that found in white women, results show.

There are likely many reasons why breast cancers are being found later, researchers said. 

For example, there’s no national organized screening program for breast cancer, and screening guidelines differ between groups like the American Cancer Society and the U.S. Preventive Services Task Force (USPSTF), the researchers noted.

The confusion may cause some women to throw up their hands and not bother with breast cancer screening, researchers said.

“Fewer than 50% of U.S. women participate in annual breast cancer screening,” Monticciolo said. “That means we don’t have the opportunity to sweep out early-stage breast cancers in huge numbers of women, who will arrive at a later stage for diagnosis.”

The USPSTF guidelines currently recommend that women 40 to 74 receive a mammogram every two years.

By comparison, the ACS recommends annual mammograms for women between the ages of 45 and 54, with mammograms every other year after 55. Women ages 40 to 44 have the option to start breast cancer screening.

“The USPSTF guidelines leave out women over age 74, despite the clear advantages of early detection,” Monticciolo said. “And younger women don’t get the chance to be screened, when as a population, they are more likely to be diagnosed with aggressive, fast-growing cancers.”

The National Comprehensive Cancer Network recommends that women undergo a breast cancer risk assessment by the age of 25, to evaluate their overall risk, researchers said.

More study is needed to fully understand these trends, particularly among Black women whose risk is greatest, researchers said.

More information

The American Cancer Society has more about breast cancer.

SOURCE: Radiological Society of North America, news release, Dec. 10, 2024

Source: HealthDay