AHRQ’s Ongoing Support for the Fight Against Breast Cancer
By Sharon Arnold Ph.D., Deputy Director of AHRQ
Signs of support for Breast Cancer Awareness Month emerge each October—pink ribbons on bumper stickers, pink sweatbands on football players, and seas of pink T-shirts on runners enrolled in charity races to “find the cure.”
But for those in the medical and research communities, every day of the year represents a chance to do battle with the most commonly diagnosed cancer among women. About 1 in 8 women will develop invasive breast cancer over the course of her lifetime, according to breastcancer.org. More than 250,000 new breast cancer cases will be diagnosed this year.
AHRQ’s role in the ongoing campaign to halt this disease is twofold.
First, we’re committed to collecting and making available the most current data to help researchers, policymakers, and health care providers track breast cancer trends. AHRQ’s Healthcare Cost and Utilization Project (HCUP) is the Nation’s most comprehensive source of hospital data, including information on inpatient care, ambulatory care, and emergency department visits. HCUP is the source for two statistical briefs that provide important insights into recent trends related to treating breast cancer:
- Mastectomies have been on the rise—especially double mastectomies. From 2005 to 2013, the rate of women undergoing mastectomies increased 21 percent. More than a third of all mastectomies were performed in hospital-based ambulatory surgery settings. Meanwhile, AHRQ’s data show a steep increase in double mastectomies; while 10 of every 100,000 women chose a double mastectomy in 2009, the rate increased to about 30 of every 100,000 women in 2013.
- More women who have mastectomies are choosing to have breast reconstruction surgery. From 2009 to 2014, the rate of reconstruction surgery after a mastectomy increased 65 percent. Data show the sharpest rise in this trend occurring among women 65 and older. And like mastectomy surgeries, breast reconstructions are taking place more often in an outpatient setting, as the rate increased 150 percent during the timeframe.
Second, the Agency supports the development of evidence reports that address important clinical questions. For example:
- What if we had more information on the prognosis of cancer to help decide on a treatment course for a breast cancer patient? AHRQ funded research in 2014 that looked at exactly this question. An AHRQ Technology Assessment explored whether molecular pathology tests, or DNA-based testing, helped clinicians and their patients understand their prognosis for several cancers. This evidence review found that more than half of 11 tests provided valid information about patients’ prognoses, and suggested that one test—the Oncotype DX® breast cancer test—helped physicians to recommend treatments that led to less exposure to the toxic effects of chemotherapy.
- An AHRQ funded research review served as the basis for the most recent breast cancer screening recommendation by the U.S. Preventive Services Task Force. AHRQ provides ongoing scientific, administrative, and dissemination support to the Task Force, which has about 100 current screening recommendations on its website. The new breast cancer screening recommendation advises women aged 50 to 74 years to get a mammography every other year. The recommendation also notes that the decision to start screening before age 50 should be an individual one, and that women under 50 with a family history of breast cancer may benefit more from screening beginning at age 40 than average-risk women.
It’s a sad truth that most of us know at least one family member, friend, or co-worker who has battled breast cancer. During Breast Cancer Awareness Month, as advocates continue to push for a cure, let’s remember that researchers and clinical teams are fighting the disease every day. AHRQ is a committed partner in these efforts, doing its part by providing data and evidence to support the battle.
This article was originally published on AHRQ Views Blog and is republished here with permission.