A question of geography

Breast cancer treatment in both the US and Britain follows similar lines – what campaigner and writer Dr Susan Love describes as the ‘slash, burn and poison approach’ – surgery, radiation and chemotherapy, followed by hormone therapy. Yet figures for the five-year survival rate for breast cancer in the US stand at 85 per cent. In this country, it is just 67 per cent. That discrepancy, that missing 18 per cent, translates into millions of lives. Why? What does the American medical community offer that its British counterparts don’t? And what lessons are there to be learnt?

More aggressive
There are a whole host of clinical reasons for the dramatic disparity in figures, not least the fact that breast cancer treatment in America tends to be more aggressive, with an emphasis on early detection. American victims have quicker access to treatment and easier access to expensive chemotherapy. Some drugs still being considered in the UK by The National Institute of Clinical Excellence (NICE) – an organisation created to ensure best practice across the country – are already widely available in the US. These include drugs for advanced breast cancer.

Clinicians in the States also perform more biopsies on suspicious lumps and are known for their willingness to try out new treatments. Early detection is also a key element of their medical arsenal. Memorial Sloan Kettering in New York, considered to be the leading cancer hospital in America, recommends a mammogram every one to two years for women over 40 – plus an annual clinical examination and monthly self examination. In this country, mammograms are not offered by the NHS until women are 50, and then are only given once every three years.

Over the page: the American psyche