Breast cancer - survival statistics

In general, when talking about cancer survival rates, five-year relative survival is most commonly reported. This is because one-year survival gives only a very short term view of prognosis whilst for ten-year survival and beyond you have to look at people diagnosed a long time ago.

However, a new method of predicting survival rates means that we are now able to estimate long term survival rates for women with breast cancer diagnoses more recently (period survival).

A common misconception is to treat survival rates as ‘cure’ rates. There are a few types of cancer for which the five-year survival rate effectively represents a 'cure' rate, although for the vast majority of cancers survival rates continue to fall beyond five years after diagnosis, most notably for women with breast cancer, among whom survival rates continue to decline more than twenty years after diagnosis.

Survival rates for breast cancer have been improving for 30 years. Figures 3.1 to 3.3 show one 1,2, five 1,3 and ten 1,4,5 year survival rates for women diagnosed with breast cancer, mainly in England and Wales. The most recent breast cancer survival rates in England are for women diagnosed in England in 2001 to 2006. For this group of women five-year relative survival is 82% (Figure 3.2). The estimated relative twenty year survival rate (Figure 3.4) for women with breast cancer has increased from 44% in the early 1990s to 64% for the most recent period 6.

One year breast cancer survival rates have increased from 82% for women diagnosed in 1971-1975 to 96% for women in 2004-2006 (England)1,2,4.

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For women diagnosed with breast cancer in 2001-2006, five-year relative survival rates have reached 82% (England only) compared with only 52% thirty years earlier in 1971-751,3,4.

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Ten-year survival rates have increased from 41% for women diagnosed in 1971-1975 to 73% for 1996-2000 1,4,5.

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The predicted twenty-year survival for breast cancer patients diagnosed in 2001-2003 is 64% 6.

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Similar increases have occurred in Scotland. Breast cancer survival rates for Scottish women diagnosed in 2000-2004 are 94% at one-year, 78% at five years, and 65% at ten years. 7

Breast cancer survival varies by age at diagnosis. For most cancers relative survival decreases with age but breast cancer is unusual in that women diagnosed in their 50s and 60s have consistently higher survival rates than either younger or older women. Figure 3.52 shows the latest five-year, age-standardised breast cancer survival rates by age for women diagnosed in 2001 to 2006.

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Figure 3.68,9 shows breast cancer survival rates at 5, 10, 15 and 20 years for women diagnosed in England between 2001-2003. Over then ten year period 1991-93 v 2001-03, survival improved for all age-groups at all end-points but the younger women had smaller improvements than women aged over 50 8. For example, ten-year relative survival increased by 13% over this period for women aged 15-49 compared with 24% for women aged 50-69 and 18% for women aged 70 to 99.

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The later the stage of the disease at diagnosis, the lower the survival rate (Figure 3.7)10. For women diagnosed in the early 1990s in the West Midlands, 5-year relative survival rates were 92% for stage I tumours, 73% for stage II tumours, 50% for stage III tumours and 13% for stage IV tumours.At ten years, the survival rates were around 5% lower for stage I  and IV tumours, and around 10% lower for stage II and III tumours.

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Analysis of breast cancer survival by level of deprivation has consistently shown higher survival for more affluent women1,11. In England and Wales in the 1970s and early 1980s the deprivation gap in five year survival was around 10%, but fell to 6% in the late 1980s. 12, 22 Although not directly comparable because the deprivation measures are not identical, five year survival by deprivation in Scotland showed a similar difference in the late 1980s.13  The deprivation gap for both countries remained largely unchanged in the 1990s, despite the fact that more affluent women attended screening.12,13

For women diagnosed in 1987 or 1993 in Scotland, affluent women under 65 were more likely to have ER positive (good prognosis) breast cancers than their deprived counterparts (65% v 48%). This difference accounted for between 20-30% of the observed 10% survival gap between the affluent and deprived.14 Other factors which may contribute to the deprivation gap in survival include co-morbidity, stage at diagnosis, and access and uptake of treatments.11

Cancer survival in Europe has been calculated since 1978 by the EUROCARE programme.15 Reports based on the latest data show that breast cancer survival has improved over time and inter-country survival differences are reducing. 9,16 However, survival in the UK is far from the best and much lower than reported in the US (Figure 3.8).16

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Note: Population coverage of the countries in the EUROCARE programme ranges from 1% to 100%. Countries without national coverage (indicated by an asterisk) cannot be deemed representative of the country as a whole.

Generally breast cancer survival rates are highest in northern Europe and lowest in Eastern Europe. Comparative survival rates are difficult to interpret as they are affected by a number of factors but more detailed studies have suggested that the lower breast cancer survival rates in the UK compared to other northern European countries are largely explained by patients having more advanced disease at diagnosis.17-19

A study of cancer survival rates across the world has recently been published.20 Five-year relative survival rates, standardised to the International Cancer Survival Standard21, were calculated for patients aged 15-99 diagnosed during 1990-94. Breast cancer survival rates varied from over 80% in North America, Sweden, Japan, Australia and Finland to less than 60% in Brazil and Slovakia and below 40% in Algeria. Most European countries including Scotland, England, Ireland and Wales, had rates in the 70-79% range.20 As with the deprivation gap, a variety of factors are likely to affect these outcomes.