IN THE NEXT 25 YEARS, PEOPLE IMPACTED BY BREAST CANCER WILL NEARLY DOUBLE. Breast cancer remains the most common cancer and a leading cause of cancer-related death for women in Australia and worldwide. Diagnoses rise each year, and global cases are expected to almost double by 2050. International studies show that approximately 20 to 30 per cent of people with early breast cancer will later develop MBC (referred to as a ‘recurrence’ or ‘relapse’). In some cases, people are diagnosed with de novo MBC, meaning their cancer is already spread beyond the breast to other parts of the body when it is first detected. For too long, people living with MBC have been ‘hidden in plain sight’ within health systems and policy frameworks, with cancer data focused solely on incidence and mortality that overlook stage at diagnosis and recurrence. Incomplete data and inconsistent collection methods have limited estimates of Australia’s MBC population. Where efforts have been made to understand the true size and needs of this population, they have largely relied on isolated, time-limited research projects rather than sustained, system-wide data collection. These challenges are not unique to Australia. For example, the United Kingdom’s estimates remain unreliable due to poor compliance with MBC data reporting legislation, and Canada’s MBC data gaps have prevented any modelling from being undertaken at all. The impact of MBC extends far beyond a person’s health outcomes – it affects both quality of life and the national economy. National productivity losses attributed to breast cancer are projected to reach $3.3 billion over a ten-year- period, 1 primarily due to reduced workforce participation and early retirement. These societal costs and financial challenges are magnified for people living with MBC. Lifelong treatment-related side effects and unpredictability of disease progression can limit people’s capacity to work. Accessing life-prolonging treatments that are not subsidised can exceed hundreds of thousands of dollars, with further financial burdens across insurance, personal debt, and superannuation. These costs are in addition to Australia’s estimated $1.84 billion annual spending (in 2023-24) on breast cancer. Growing pressure on health system budgets, particularly since the COVID-19 pandemic, has exposed how people living with MBC remain absent from health planning and funding models. Harmonised methods and accurate data systems are essential to quantify need, guide resource allocation, and deliver sustainable, person-centred care focused on wellbeing and living well.
High -quality MBC data is both powerful and empowering. These data are essential to adequately plan, treat and support people with MBC. But the power of these data goes much further: it breaks down stigma by demonstrating to the world that millions of people with MBC globally are essential to the fabric of society. It also shows their rich contribution to families, communities, and the economy through paid and unpaid work. The Lancet Breast Cancer Commission calls for cancer registeries globally to record relapses for all cancers. The outstanding advocacy work by Breast Cancer Network Australia has catalysed this process and will provide a blueprint for the rest of the world to follow. – Professor Charlotte Coles, Chair of the Lancet Breast Cancer Commission
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