There is more good news in the battle against breast cancer. Newly released figures show that deaths continue to decline, dropping about 2 percent a year since 1990.

The drop was most dramatic among women under the age of 50, whose breast cancers tend to be more aggressive and harder to treat. The number of breast cancer deaths for this age group declined by 3.3 percent annually between 1990 and 2002.

The figures were published today by the American Cancer Society, which reports each year on breast cancer trends. ACS officials credited earlier diagnosis and better treatments for the “slow, steady drop” in breast cancer deaths over the 12-year period.

Breast cancer education efforts aimed at American women have also had an impact, says ACS director of cancer screening Robert Smith, PhD.

“Women know a lot more about breast cancer than they did 20 years ago,” Smith tells WebMD. “They are far more likely to report the first signs and symptoms of breast cancer promptly. And doctors today are more alert to breast cancer and less likely to dismiss a patient’s concerns.”

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Ethnic Disparity Persists

But all the news is not good. Survival among black women with breast cancer continues to lag well behind that of white women. Whereas 90 percent of white women are alive five years after being diagnosed, that number drops to 76 percent among African-Americans.

A similar disparity has been reported for Hispanic women and other racial and ethnic groups in the U.S. that are disproportionately poor.

The ACS report cites later breast cancer diagnosis as a major factor in the survival disadvantage, and it has called on the U.S. government to increase funds for screening poor women.

The CDC has a program in place to provide mammograms and treatment to economically disadvantaged women. But the program has funds to screen only about one in five women who qualify.

“Income level should not determine whether someone survives breast cancer,” ACS president Stephen F. Sener, MD, says in a news release that calls on Congress to increase funding for screening and treatment by $45 million.

Smith points out that many private groups also offer mammograms and follow-up care to medically underserved women. But he acknowledges these private programs may be difficult to find.

“Like everything else it is harder for poor women, and it shouldn’t be that way,” he says. “They should have the same access to screening and follow-up care as other women.”

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Breast Cancers Rise Slightly

Despite the declines, breast cancer continues to be the No. 2 cancer killer among women, behind lung cancer. This year, an estimated 211,000 women will be diagnosed with breast cancer in the United States and 40,000 are expected to die from the disease.

Breast cancer frequency continued to rise slightly -- 0.3 percent per year -- among women aged 50 and over between the late 1980s and 2002 (the last year for which figures are available).

As a population, American women are delaying childbearing and have fewer children than they did in the past. These trends have been linked to breast cancer risk and are believed to be major contributors to the increase.

Breast cancer rates did decline slightly among women between the ages of 40 and 49, and there was little change among younger women.

Other highlights of the report include:

--The average age at diagnosis is 61 for women in America. Roughly half of women were younger and half older when their breast cancer was discovered.

--Breast cancers among men increased by about 1% each year between 1975 and 2002. Researchers are at a loss to explain the increase. Projections are that 1,700 men will be diagnosed with the disease in 2005 and 460 will die.

--Breast cancer accounts for one out of three new cancers among women living in the United States.

--Approximately 2.3 million women living in the U.S. today have been treated for breast cancer. That number includes both survivors who are cancer-free and women undergoing treatment.

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Get Your Mammogram on Time

Smith tells WebMD that the downward trend in breast cancer deaths is likely to continue and would be even more dramatic if more women aged 40 and over followed the ACS recommendations to get a mammogram every year.

Annual screening is critical, he says, because a year can make the difference between a highly curable breast cancer and one that is more difficult to treat.

A big problem, he says, is that far too few physicians let their patients know when it is time for their annual mammogram.

“The fact is that few of us do anything on time unless we are reminded,” he says. “We get reminders when it is time to go to the dentist or take our animals to the vet. But women aren’t being reminded about annual mammograms.”

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By Salynn Boyles, reviewed by Michael W. Smith, MD

SOURCES: American Cancer Society Breast Cancer Facts and Figures, 2005-2006. Robert Smith, PhD, director, cancer screening, American Cancer Society, Atlanta. Stephen F. Sener, MD, president, ACS.