US Breast Cancer Mortality

To the Editor In their recent study, Dr Caswell-Jin and colleagues used 4 Cancer Intervention and Surveillance Modeling Network (CISNET) models and ascribe the 58% reduction in US breast cancer mortality between 1975 and 2019 to the use of effective treatments and screening. However, the CISNET models do not appear to account for the effect of declining estrogen receptor (ER) –negative breast cancer incidence on overall US breast cancer mortality rates. The US Surveillance, Epidemiology, and End Results (SEER) database first began recording breast cancer ER status in 1992, and between the years 1992 and 2016, age-adjusted ER-negative breast cancer incidence rates decre ased for all age groups of non-Hispanic Black, Hispanic White, and non-Hispanic White women in the US. Breast cancer mortality rates are substantially higher for patients with ER-negative breast cancers compared with those with ER-positive cancers, but treatments and screening have been primarily ef fective in lowering mortality rates for patients with ER-positive breast cancers. Thus, the decline in ER-negative breast cancer incidence, for reasons that are not entirely clear, has likely contributed substantially to the overall reduction in US breast cancer mortality.
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research