The new Lancet commission warns that people with metastatic breast cancer have been often forgotten and leaves recommendations

Lisbon, 16 April 2024 – The new Lancet Commission on Breast Cancer today released findings and recommendations on improving breast cancer care globally. Over the past two years, the international multidisciplinary group of experts, including Dr Fatima Cardoso, president of the Advanced Breast Cancer (ABC) Global Alliance, has worked to transform the breast cancer care landscape. Supported and funded in part by the ABC Global Alliance, the commission has led debate around key issues, supported pilot studies, culminating it its landmark report to help reduce the impact of breast cancer on society.

Breast cancer is the most common cancer in the world, with at least 7.8 million women living with breast cancer at the end of 2020. That same year saw an estimated 685,000 deaths from the disease, and an additional 2.3 million people diagnosed. This is forecast to worsen, with an expected 3 million annual diagnoses by 2040, and one million annual deaths expected, with low- and middle-income countries disproportionately affected.

Recent progress in research and treatment has helped reduce the number of deaths from breast cancer, with decreases of up to 40% in some high-income countries. However, breast cancer still poses an enormous burden worldwide, with the Commission stating, “society, governments and decision-makers in the health sector only see the tip of an iceberg.”

Inequities in healthcare, along with the hidden costs of breast cancer, mean that many women and some men are being left behind and forgotten. This is a global problem, with the Commission highlighting key barriers that prevent progress in its report advocating for six crucial areas for change.

One such areas in metastatic or advanced breast cancer. The report notes that 20 to 30% of patients with early breast cancer suffer recurrences that are not usually documented by most national oncology registries. As a result, the number of patients living with metastatic breast cancer, already a poorly understood disease, is unknown. The authors argue that at least 70% of oncology registries worldwide must better document the stage of the disease upon diagnosis, as well as relapses, to accurately reflect the prevalence and impact of the disease. This would be supported by the improvement of early diagnosis programs, with the commission aiming for 60% of invasive cancer cases diagnosed in stage I or II.

“Patients living with metastatic/advanced breast cancer (MBC/ABC) have long suffered from stigma, misconceptions, and abandonment not just from society in general but also from healthcare providers and patient advocacy groups. There is an urgent need for change in the way metastatic breast cancer is understood and managed. With this change, it will be possible to treat most, alleviate suffering for all, and forget no-one living with MBC/ABC. This is one of the strongest messages from the new Lancet Commission on Breast Cancer, which is totally aligned with the long-lasting fight from the ABC Global Alliance.”, says Dr Fatima Cardoso, the ABC Global Alliance President and director of the Breast Unit at the Champalimaud Clinical Center, Lisbon, Portugal.

The report also stresses the importance of improving communication with patients, stating all healthcare professionals in the world should receive training in communication skills to allow them to better involve patients in all stages of cancer care.

The report further states there are many costs – physical, psychological, social and financial – that are poorly recognized or not captured by current global health indicators, a gap that the Commission argues must be addressed urgently by developing new tools and metrics.

The new Lancet Commission on Breast Cancer started to work in 2021 with the commitment to raise the standard of breast cancer care and to close the equity gap that exists between and within countries. The recommendations to face the urgent challenges for breast cancer patients will be released this Tuesday, April 16, at 2 pm, in an online session.

Registration can be done via the link: https://www.eventbrite.co.uk/e/lancet-breast-cancer-commission-report-launch-tickets-862423932197).
The Commission's work was funded and supported by the National Institute for Health and Care Research (NIHR), Breast Cancer Now, the ABC Global Alliance and the University of Cambridge.