ABC Global Alliance's landmark Advanced Breast Cancer Global Decade Report 2015–2025 was recently released and published in The Breast. The report highlights significant advancements made over the past decade that have transformed care for patients with advanced breast cancer, but also reveals gaps in multidisciplinary care and equity internationally that require urgent attention.
"Progress over the last decade has been meaningful, but uneven. While some patients now live longer and better, many still lack access to basic diagnostics, treatment, coordinated care, and workplace protections," the study authors wrote in the Global Decade Report.
"This landmark global report marks a pivotal moment," said corresponding author Fatima Cardoso, MD, Director of the Breast Unit, Champalimaud Clinical Center President, ABC Global Alliance, Lisbon, Portugal, and President of the ABC Global Alliance. "We've proved that progress is possible, and now we must evolve our expectations to meet patients' needs today. This new charter is grounded in evidence, driven by the urgent need to turn proven potential into standard practice for all patients, in all regions, in all circumstances. Our ambition is to ensure that every person living with advanced breast cancer has the chance to live as well as possible, for as long as possible—not just those in wealthy nations or with specific subtypes."
Fatima Cardoso, MD
The ABC Global Alliance also set out 10 goals for advancing care for patients with advanced breast cancer globally for 2025–2035, which was also announced during the Advanced Breast Cancer Eighth International Consensus Conference.
Background
The Global Decade Report was first published for 2005–2015, prior to the establishment of the ABC Global Alliance in 2016. The first report addressed critical issues in patient care and scientific research for patients with advanced breast cancer, and stressed the need for coordinated action to correct gaps in diagnostics and treatment for patients.
The ABC Global Charter made a set of 10 ambitious goals for transforming care for patients with advanced breast cancer for the next decade and has since fought to inspire and make changes in terms of research and policy.
The ABC Global Decade Report 2015–2025 now assesses how far the world has come in achieving those goals and improving care for patients with advanced breast cancer.
Report Methods
To assess progress over the past decade, the ABC Global Alliance conducted extensive primary and secondary research, including two global digital surveys targeting the perspectives of both health-care professionals and patients, which was conducted from March to June 2024. The health-care professional survey received 461 responses across 78 countries, and focused on topics of care delivery, communication, and current practices in the treatment of advanced breast cancer. The patient survey received 1,254 responses across 59 countries, and focused on the experiences of patients living with advanced breast cancer, including access to care, decision-making, quality of life, emotional impact, and more.
Additionally, the authors conducted a clinical targeted literature review of the efficacy of treatments for patients with advanced breast cancer from clinical trials over the past decade.
The authors also looked at global registries, studies of health-related quality of life, documentation of multidisciplinary team care integration, interviews, and more.
Key Findings of Progress
The 2015–2025 report revealed that the 5-year median overall survival rate for women with advanced breast cancer has risen from 26% in 2015 to 33% in 2025. Real-world data for patients with HER2-positive disease in select regions shows median survival times of longer than 50 months.
Greater access to data has also provided the first reliable estimates of advanced breast cancer incidences in countries such as Australia and Northern Ireland.
International consensus guidelines for the management of patients with advanced breast cancer have been implemented into practice across multiple regions, but not globally. Additionally, there are ongoing conversations around patients' quality of life, stigma, workplace rights, and psychological support.
Ongoing Gaps in Care
Despite these areas of progress, there are still significant areas of unmet needs globally. The median overall survival for advanced triple-negative breast cancer, specifically, has only risen by less than 3 months over the past decade, from 10 to 13 months.
Depending on where they live, patients do not have the same access to biological or targeted therapies—for example, trastuzumab is only available in about 51% of low- to middle-income countries vs in 93% of high-income countries.
More than half of all patients with advanced breast cancer (55%) report that they have never been offered any support services by their health-care team.
Additionally, no comprehensive legal framework has been effectively implemented in any country to protect the working rights of patients with advanced breast cancer as well as those of their caregivers.
The two global surveys revealed that 79% of patients report that their breast cancer has a negative impact on their emotional and psychological wellbeing, yet only 53% of health-care providers regularly refer their patients for psychological support services.
The majority of patients (79%) had never participated in a clinical trial.
High out-of-pocket treatment costs remain a global issue.
Seventy-three percent of patients with advanced breast cancer reported that their cancer affects their ability to work or study, and 47% reported feeling stigma and isolation about their cancer journey.
For the Next Decade
Looking ahead to 2025 through 2035, the ABC Global Alliance set out the following 10 goals for the ABC Global Charter 2.0:
- Further improve survival outcomes in patients with advanced breast cancer by doubling median overall survival.
- Optimize care and outcomes for patients with advanced breast cancer by collecting high-quality data.
- Improve quality of life for patients with advanced breast cancer.
- Ensure that every person with advanced breast cancer is treated and cared for by a specialized multidisciplinary team in accordance with high-quality breast cancer guidelines.
- Improve communication between health-care professionals and patients with advanced breast cancer and their caregivers.
- Meet the informational needs of all patients with advanced breast cancer.
- Ensure all people with advanced breast cancer have access to comprehensive, patient-focused support services.
- Reduce misconceptions, stigma, and isolation for patients by improving the overall understanding of advanced breast cancer.
- Improve access to comprehensive care for patients with advanced breast cancer, regardless of their ability to pay.
- Improve the legal rights of patients with advanced breast cancer, including the right to continue or return to work.
“This report shows what a decade of collective action can achieve, proving that progress isn’t theoretical—it transforms lives. Yet progress is not the same as equity. Our challenge and commitment is to close the gaps in ABC care within and between countries," Dr. Cardoso concluded.
Disclosure: For full disclosures of the study authors, visit thebreastonline.com.
