[Jackie07]

The abstracts below show stable/improvement in all areas of breast cancer survival. (The reason why those 'Textbook' statistics are so scary/depressing is because of the time lag in publication. We used to have a saying in library school that 'anything that's been published is old'. Books - especially textbooks - usually contain dated information. This link in Wikipedia may provide a glimpse of the process: http://en.wikipedia.org/wiki/Publishing )

CA Cancer J Clin. 2011 Oct 3. doi: 10.3322/caac.20134. [Epub ahead of print]
Breast cancer statistics, 2011.
Desantis C, Siegel R, Bandi P, Jemal A.
Source
Epidemiologist, Surveillance Research, American Cancer Society, Atlanta, GA. carol.desantis@<font face="Arial">cancer</font><fon...l">.org</font>.
Abstract
In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including trends in incidence, mortality, survival, and screening. Approximately 230,480 new cases of invasive breast cancer and 39,520 breast cancer deaths are expected to occur among US women in 2011. Breast cancer incidence rates were stable among all racial/ethnic groups from 2004 to 2008. Breast cancer death rates have been declining since the early 1990s for all women except American Indians/Alaska Natives, among whom rates have remained stable. Disparities in breast cancer death rates are evident by state, socioeconomic status, and race/ethnicity. While significant declines in mortality rates were observed for 36 states and the District of Columbia over the past 10 years, rates for 14 states remained level. Analyses by county-level poverty rates showed that the decrease in mortality rates began later and was slower among women residing in poor areas. As a result, the highest breast cancer death rates shifted from the affluent areas to the poor areas in the early 1990s. Screening rates continue to be lower in poor women compared with non-poor women, despite much progress in increasing mammography utilization. In 2008, 51.4% of poor women had undergone a screening mammogram in the past 2 years compared with 72.8% of non-poor women. Encouraging patients aged 40 years and older to have annual mammography and a clinical breast examination is the single most important step that clinicians can take to reduce suffering and death from breast cancer. Clinicians should also ensure that patients at high risk of breast cancer are identified and offered appropriate screening and follow-up. Continued progress in the control of breast cancer will require sustained and increased efforts to provide high-quality screening, diagnosis, and treatment to all segments of the population. CA Cancer J Clin 2011;. © 2011 American Cancer Society.
Copyright © 2011 American Cancer Society, Inc.


Ann Oncol. 2011 Oct 14. [Epub ahead of print]
Long-term (37 years) clinical outcome of older women with early operable primary breast cancer managed in a dedicated clinic.
Syed BM, Johnston SJ, Wong DW, Green AR, Winterbottom L, Kennedy H, Simpson N, Morgan DA, Ellis IO, Cheung KL.
Source
Divisions of Breast Surgery.
Abstract
BACKGROUND:
A dedicated clinic for older women with early primary breast cancer, established in 1973, has recently evolved into a combined surgical/oncology facility. This study aimed to compare the clinical outcome across these periods.
METHODS:
From 1973 to 2010, 1758 women were managed. Analysis was carried out based on retrospective review and continued update of patient records.
RESULTS:
In the recent decade, 56.3% had surgery, followed by primary endocrine therapy (PET; 41.1%) and primary radiotherapy (1.5%). Before 1999, 42.8%, 55.6% and 1% of patients had surgery, PET and primary radiotherapy, respectively. The use of adjuvant endocrine therapy and radiotherapy has increased from 33.6% to 54.9% and 5.8% to 34.6%, respectively. A significant improvement was seen in the annual rates of local (2.2% versus 0.5%, P < 0.001), regional (1.8% versus 0.4%, P < 0.001) and distant (2.9% versus 1.9%, P = 0.002) recurrences. Similarly, the 5-year breast cancer-specific and overall survival rates showed improvement [81% versus 91% (P < 0.001) and 56% versus 71% (P < 0.001), respectively].
CONCLUSIONS:
In the recent decade, while surgery became the predominant treatment, a significant proportion of patients had non-operative therapies, selection of which was based on multidisciplinary assessment in the clinic. This management approach appears to produce excellent clinical outcome, which is significantly better than that in earlier period.