Summary: Twenty years ago, President Nixon launched the "war on cancer" with the signing of the National Cancer Act. This report reviews progress in prevention and treatment of breast cancer over the past two decades and determines what kinds of research are needed to help prevent breast cancer and improve survival rates. GAO concludes that while many breast cancer patients are living longer and their quality of life has improved, the struggle against the "dread disease" has not been won. The expectation is that the coming year will see more women stricken with the disease and more women dying from it than two decades ago. On the positive side, medical detection, diagnosis, and treatment of breast cancer have improved because of widespread availability of technologies like mammography. In addition, breast cancer surgery has been refined, with the Halstead, or radical mastectomy--and its disfiguring results--becoming much rarer. In examining breast cancer research, GAO concludes that gaps in fundamental knowledge about the etiology of breast cancer (causes and their mode of operation) are the critical obstacles to more effective detection, diagnosis, and treatment. Further, identifying chains of events leading to the onset of breast cancer and learning how to interrupt those sequences are the primary prerequisites for preventive measures. GAO summarized this report in testimony before Congress; see: Breast Cancer: Progress to Data and Directions for the Future, by Richard L. Linster, Director for Planning and Reporting in the Program Evaluation and Methodology Division, before the Subcommittee on Human Resources and Intergovernmental Affairs, House Committee on Government Operations. GAO/T-PEMD-92-4, Dec. 11, 1991 (six pages).
