When we were invited to be a member of the Metastatic Breast Cancer Alliance in February 2013, I was both honored and discomfited. Honored, because breast cancer has been my life’s work. Discomfited, because I am well aware that, although the breast cancer movement has achieved many successes, like increased awareness, improved access to mammography for early detection, and expanded patient involvement in clinical trials, we have often failed to address or meet the needs of women and men living with metastatic breast cancer We are very good at creating awareness and celebrating survivorship. We are less good at acknowledging that we have not done enough for the 40,000 women and men who die from breast cancer each year in the United States. Or for the women and men whose first diagnosis of breast cancer is stage IV—many of whom are probably amazed to learn that the rate of an initial diagnosis of metastatic breast cancer has not dropped since 1975. To achieve a future without breast cancer, our ultimate goal has to be preventing the disease in the first place. The mere fact that women still get metastatic breast cancer despite “early detection,” and the money poured in to finding a “cure” is reason enough that we also need to find the cause. A new report by the Metastatic Breast Cancer Alliance, “Changing the Landscape for People Living with Metastatic Breast Cancer,” was developed with the clear intent of moving metastatic breast cancer to the forefront of efforts to improve breast cancer outcomes, and help us achieve our ultimate goals. To be sure, over the past two decades we’ve seen the introduction of new targeted therapies that reduce the risk of recurrence and that are helping people with metastatic disease live longer. There is also important ongoing research into immunotherapies, like vaccines, that some initial studies suggest can decrease the risk of recurrence. The Second International Consensus Guidelines for Advanced Breast Cancer that were published simultaneously in the Annals of Oncology and The Breast were created to help ensure that as many people as possible benefit from the latest research findings on treatments for metastatic breast cancer. Yet the guidelines also make clear that all too often doctors don’t have the high quality data they need to help their patients make informed treatment choices. The international guidelines also make a “plea for a strong commitment of all involved parties (academia, pharmaceutical industry, independent funding sources, and advocacy groups) to develop well-designed, high-quality multidisciplinary (involving other issues than drug-development) trials…” I could not agree more. We must conduct meaningful research on patients with metastatic breast cancer—research that will benefit them by increasing not only their length of life but their quality of life as well. My personal goal—and that of Dr. Susan Love Foundation for Breast Cancer Research—is creating a future without breast cancer. That means finding the cause, so we can prevent it. But it also means finding the cure and being part of the effort to recognize that we need to fund the research that will give the women and men currently living with metastatic breast cancer the best possible chance of being here when that day arrives.

 

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