Groundbreaking experimental vaccines could finally eliminate one of the most common cancers in women and help America win the war on cancer.
Each year, more than 264,000 women are diagnosed with breast cancer. It is the most common cancer in women in America, with more than 43,000 deaths from the condition each year.
But death rates fell 43 percent between 1989 and 2020, following successful public health awareness campaigns, better screening and new drugs.
The graph above shows the number of breast cancers in women as a percentage per 100,000 people compared to the death rate represented by the red squares. While death rates have fallen, cases are still rising
The number of new cases has remained fairly stable between 1992 and 2020, remaining around 130 per 100,000 women.
But the number of new breast cancer cases is rising about two percent each year, John Wong, an internist and professor of medicine at Tufts University School of Medicine, told the Washington Post.
Modern mammography methods were developed in the late 1960s and were first officially recommended by the American Cancer Society in 1976. It is still the most trusted way to screen for breast cancer.
The first mastectomy – a way to treat breast cancer by surgically removing the entire breast – was performed in 1882 by the American surgeon William Halstead. To this day, this is the standard operation for breast cancer.
According to the National Cancer Institute, a double mastectomy reduces the risk of developing breast cancer by at least 90 percent for women with a strong family history.
In 1937, radiation therapy was introduced, as was surgery to save the breast. After the tumor is removed, needles containing radium are placed in the breasts and near lymph nodes.
In 1978, Tamoxifen was approved by the Food and Drug Administration (FDA) for use in the treatment of breast cancer.
The graph above shows the changes in breast cancer screenings (black line) per month since 2017. It also shows a predicted screening rate (dotted yellow line) and the Covid infection rate (blue line) in the US over the same period. Screenings were initially stable, but dropped by as much as 14 percent in the first year of the pandemic
The anti-estrogen treatment was the first in a new class of drugs called SERMs — selective estrogen receptor modulators.
Eighteen years later, the FDA approved anastrozole (Arimidex) for the treatment of breast cancer. The drug blocks the production of estrogen.
Numerous other drugs have since been approved. One of the more recent, Trodelvy, was approved by the FDA in 2020. It treats triple-negative breast cancer that has spread in people who have not responded to at least two other treatments.
In May, a leading health panel recommended reducing the age at which women are regularly screened for breast cancer from 50 to 40 years.
The US Preventive Services Task Force (USPSTF) said that 20 million women in their 40s would benefit from a mammogram every two years.
The change would save 20 percent more lives, according to the USPSTF, which drafted the proposal in response to rising rates among middle-aged women.
Currently, all women aged 50 to 74 are advised to get checked every two years via a mammogram – a low-energy X-ray of their breasts.
The advent of chemotherapy drugs in the 1970s increased survival rates across the board. But it wasn’t until the generic versions of the drugs became available in the 1980s that access became widespread.
Treatment options for breast cancer include surgery, chemotherapy, radiotherapy, and hormone treatment. Often a combination of two or more of these treatments is used.
Radiotherapy uses high-energy beams of radiation aimed at cancerous tissue.
This kills cancer cells or prevents them from multiplying. It is mainly used in addition to surgery.
A patient may have breast-conserving surgery or have the affected breast removed, depending on the tumor size.
Medical professionals have identified genetic mutations that put women at high risk of developing breast cancer.
Some of these women opt for a voluntary prophylactic mastectomy – the surgical removal of both breasts, even if they are completely healthy at the time, to reduce the risk of breast cancer.
Angelina Jolie famously spoke out about her decision to have a double mastectomy and reconstruction in 2013.
This led to the ‘Angelina Jolie’ effect – an increase in genetic testing for breast cancer.
Chemotherapy, a cancer treatment using anticancer drugs that kill cancer cells or prevent them from multiplying, is commonly used.
Some types of breast cancer are influenced by the ‘female’ hormone estrogen, which can stimulate cancer cells to divide and multiply.
Therapies that lower the level of these hormones or prevent them from working are commonly used in people with breast cancer.
Now a new set of treatments is emerging: cancer vaccines to treat and prevent cancer.
One vaccine, developed at the famed Mount Sinai Hospital in Manhattan, New York, quickly melts away the primary tumor and teaches the body to hunt down and kill cancer cells that have spread elsewhere.
Two women with breast cancer were put into partial and complete remission after receiving the vaccine, which is not for the faint hearted, in a clinical trial.
Patients receive 17 injections in the tumor and another eight in their arm over six months.
Meanwhile, a new vaccine for triple-negative breast cancer, co-developed with Anixa Biosciences and Cleveland Clinic, also sparks hope for a cancer-free future.
Unlike most cancer shots that are being trialled and given to patients after diagnosis, the new shot is given to cancer survivors to prevent relapse or healthy years ahead of time.
The vaccine has several major hurdles to overcome, including large-scale human trials and Food and Drug Administration approval, but Dr. Amit Kumar, CEO of Anixa Biosciences, the company developing the vaccine, told DailyMail.com that if they go well, “Maybe we can eradicate breast cancer as a disease, just as we have eradicated polio and smallpox.”
President Joe Biden declared war on cancer in the US last year, promising to halve the number of deaths from the disease within 25 years.
The National Institutes of Health recently declared this ambition “impossible.”
Lung and breast cancer have seen the biggest improvements in falling mortality rates to date, which experts say is due to successful awareness campaigns and healthier habits.
But there are concerns that some of the gains made have been lost in the early stages of the pandemic, after many avoided healthcare.