Whether a woman was diagnosed one hundred and fifty years ago or this morning, the diagnosis is devastating.

What has changed dramatically is that the survival rates for some breast cancers is as high as 98% and there are more reasons than ever to be optimistic. Many women today don’t remember a time when the only way they could be diagnosed with breast cancer was if the tumor was big enough to see or feel. Today, modern technology can find very small tumors and cure them even before the first symptoms appear. I think it might be good to take a look back at how far we’ve come.

In 1992, Evelyn Lauder put the spotlight directly on breast cancer research for the first time. She co-created the now iconic pink ribbon and launched the Breast Cancer Research Foundation®, a non-profit organization dedicated to breast cancer research. The pink ribbon, so simple and powerful at the same time, became a worldwide movement that has funded research that has significantly changed the outcomes of millions and millions of women throughout the world.

Through Evelyn Lauder’s hard work, “As breast cancer now has the global spotlight it deserves, the goal of increasing breast cancer “awareness” has moved into the future with a new rally – it’s time to end breast cancer. As a result of the hard work of Evelyn Lauder’s hard work and fundraising:

• Breast cancer mortality rates have decreased by 38% since the late 1980s.
• Five-year survival rates are better than 90% when breast cancer is found early.
• Treatments are being customized to a person’s type of breast cancer, as breast cancer was revealed to be not one disease, but several different types
• Surgery is not as invasive, and most women can have a lumpectomy and not a full breast removal (mastectomy)

So, whether you have run or walked, donated your time or money, held a loved one’s hand during her first chemotherapy treatment or her last, your time and devotion has made a real difference to real women. In case you’ve forgotten where we’ve been, and how far we’ve come, here is a brief history of breast cancer treatments and survival rates over the last hundred and fifty years:

Surgical Advances – Between 1880 and 1940, the first line of treatment for a woman diagnosed with breast cancer was a radical mastectomy. This involved the complete removal of the breast, chest muscles, and underarm lymph nodes. By the late 1940, this
approach was changed to a modified radical mastectomy which left the chest muscles intact. This is the procedure that my grandmother had in 1951. Despite this disfiguring surgery, the cancer spread to her brain and she died three years later at forty two. Less than twenty years later, doctors began limiting the scope of the surgery to just the removal of the tumor and a small amount of surrounding tissue. This is what is commonly referred to as a lumpectomy and is the treatment of choice offered to many women. It took over a hundred years for research to show that the lumpectomy combined with radiation therapy was as effective as the mastectomy in terms of survival rates. That was in 1985, thirty-two years ago.

Advances in radiation treatment – Just after radical mastectomies were performed to remove breast tumors, doctors realized that radiation could be used to shrink cancerous tumors.

Chemotherapy – The first chemotherapy was introduced around 1940. It was found to reduce tumor size before surgery, prevent recurrence, and treat cancer that had metastasized or spread to other organs in the body. Chemotherapy continues to be an important treatment for breast cancer, and while it still produces unpleasant side effects including nausea, exhaustion and bone marrow toxicity, it is much less punishing today. Also, there is an influx of new drugs being developed all the time and exciting new drugs help with the side effects chemotherapy causes.

Advances in Diagnosis – The one thing about breast cancer that everyone agrees with is that early detection saves lives. Starting in the early 1950s, steady advances in mammography are credited with raising the 5-year survival rate for localized breast cancer from 80% to 98%. Mammography is clearly the first line of defense. It is the number one method of early breast cancer detection, and we know early detection gives most breast cancer patients the greatest chance of survival. The following methods have been used over the years for detection:

Standard Mammography – After 1967, diagnostic mammography gained popularity with the introduction of equipment specifically for breast x-rays. In the beginning, mammography was only used to further analyze abnormalities that had already been identified once a tumor was discovered. Then, beginning in 1980, in a seminal shift in the importance of early detection, screening mammograms became a routine test for all women age 40 and over.

Three-Dimensional Mammography – In 2011, the FDA approved three-dimensional mammography which produced clearer images in order to pinpoint more cancers and cut the number of repeat mammograms in half.

Ultrasound – To help determine if a cyst was solid or liquid in an attempt to see whether or not it was malignant, doctors began using ultrasound to be able to better make an initial diagnosis.

MRI – In 2007, the American Cancer Society recommended yearly MRIs for women at high risk for breast cancer. This test is very expensive and it is still only available in big cities. By continuing to pressure insurance companies to pay for this potentially life saving test, we hope to make it available to all women as soon as possible.

Pharmaceutical Breakthroughs for Breast Cancer

Selective Estrogen Receptor Modifiers fight cancers that need estrogen to grow by limiting the ability of estrogen to enter the cancer cell. In high-risk women, tamoxifen was found to reduce recurrence and the development of invasive breast cancer by 50%
when taken over a 5-year period.

Aromatase Inhibitors — For post-menopausal women, aromatase inhibitors –work by reducing the estrogen available to cancer cells and have been found to be more effective than tamoxifen in women who are postmenopausal and who have estrogen positive breast cancer.

Targeted Hormonal Therapies – Herceptin (trastuzumab) is a targeted therapy that specifically binds to a particular form of breast cancer that has too much of the HER2/neu protein on its surface. It destroys the cancer cells, but very little healthy tissue. Herceptin paired with chemotherapy cuts recurrence of HER2/neu-positive breast cancer by 50%.

Prevention and Genetic Testing for Breast Cancer

Every woman should know what they can do to help reduce the risk of breast cancer. Some important considerations include healthy eating, regular exercise, keeping at a healthy weight, and avoiding excessive alcohol. For many, many years, breast cancer clusters were showing up in specific geographical places in the US. Researchers started to investigate a pattern in hope that they could discover something different in these women in hope that it might help new therapies and might possibly lead to a cure. In the late 1990s, what they found was that certain variants of the genes BRCA1 and BRCA2 cause up to an 80% increase in risk for breast cancer.

Experts agree that genetics is the next frontier. Future strategies may involve genetic testing to individualize patient treatment and even techniques to repair or replace harmful genes before breast cancer occurs.

So ladies and gentlemen, never stop tying your sneakers and walking or running to raise money for breast cancer research. When you want to make a charitable contribution, consider a breast cancer charity for the sake of all the women in our lives we love so dearly. We have come so far, especially in just the last few years. My grandmother Shirley died two months before the birth of her first grandchild and namesake. If only she were alive today to have so many new treatments treatment options.

Yes, we sure have come a very long way, but we still have a long way to go. A few weeks ago, someone sent me an email saying after five years her breast cancer had returned. She wrote, “I don’t want you to take this the wrong way, but I hope someday you go out of business. “ At first I didn’t understand. Then, I realized that when the last woman has died of breast cancer, I would no longer need to make jewelry to raise money for cancer charities. Nothing I can think of can think of would make me happier.

Since its founding in 1993 by Evelyn H. Lauder, The Breast Cancer Research Fund (BCRF ) has raised more than half a billion dollars for lifesaving research. Through a unique and streamlined grants program, they have assembled the brightest minds in science and medicine and given them the necessary resources to pursue their best ideas. As a result, researchers are able to make discoveries and design new approaches to address all aspects of breast cancer—and do so in record time.

Information obtained from the BCRF website at www.bcrf.org

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