The Impact of High-risk and Metastatic Breast Cancer

Based on the National Cancer Institute's SEER data, the American Cancer Society has estimated that in the year 2003, over 211,300 cases of female invasive breast cancer will be newly diagnosed in the United States, and 39,800 women will die of the disease. About 1,300 new cases of breast cancer in men will be diagnosed this year, and 400 will die. While breast cancer is the most common cancer diagnosed in women, it is the second leading cause of cancer death, outstripped only by lung cancer, a number that is now falling in California. A full 15 percent of all cancer deaths in women are from breast cancer.14

Accounting for 10 percent or more of the total cases in the United States, the State of California is home to the largest number of new diagnoses and deaths from breast cancer of any state. In California, 23,711 women were diagnosed with invasive breast cancer and 4,152 women died each year of the disease during the period 1995–1999.15

How can we measure this impact, and put it in the proper context? In early-stage breast cancer, it may be meaningful to consider the impact of surgical interventions and radiation, the other side-effects and costs of adjuvant care, and post-treatment issues, including the fear of possible recurrence. When discussing high-risk and metastatic breast cancer, the more appropriate assessment of impact is clearly the loss of life.

But the actual death rates tell only a part of the story. It is important to note that loss of life is only the final loss to breast cancer patients, their families and their communities. Each breast cancer death is inevitably preceded by years of difficult, painful, and costly treatment, by loss of the ability to fulfill roles within the family and community, and by loss of income and productivity. The sum of all these losses is incalculable.