By Dr. Jenn Simmons MD.
Breast cancer remains one of the most commonly diagnosed cancers in women. And while we’ve been led to believe that we’re making major strides in reducing breast cancer mortality, it’s time to look a little closer—and ask some uncomfortable questions.
Are women really surviving breast cancer at higher rates? Or are we just diagnosing more women with early-stage, non-lethal disease that never would have harmed them? Are we truly saving lives—or simply increasing suffering?
Absolute Mortality: A Closer Look
We’re constantly told that breast cancer “survival is improving.” We're patting ourselves on the back for catching cancer early and treating it aggressively. But here’s the truth: the absolute number of women dying from breast cancer hasn’t changed.
According to the National Breast Cancer Coalition, an estimated 42,170 women and 510 men will die of breast cancer in 2025—a number that’s been essentially flat for the past 10 to 15 years. Despite earlier detection and new treatments, the total number of deaths has not gone down. [1]
So, why do the statistics make it look like breast cancer survival is improving?
Simple: we’re increasing the denominator. By diagnosing more “cancers”—many of which are biologically insignificant or non-lethal—we make it look like the percentage of people dying from breast cancer is lower. This is overdiagnosis in action, and it’s manipulating our perception of success.
Overdiagnosis and Overtreatment
So, what’s the harm in catching a “good cancer”? Isn’t early detection always better?
Not when it leads to unnecessary, life-altering treatment.
Overdiagnosis leads to overtreatment—and overtreatment carries consequences which are sometimes dire. We’re putting women through surgery, radiation, hormone suppression, and chemotherapy for conditions that may never have harmed them. And these treatments are not benign. They change women—permanently.
This is why I wrote The Smart Woman’s Guide to Breast Cancer. Because too often, women are rushed into treatment without a full understanding of the risks they’re taking on. We treat breast cancer like a medical emergency. In many cases, it’s not. Yet we launch a cascade of interventions that often rob women of their health, confidence, and quality of life.
To be clear: I am
not saying breast cancer isn’t a serious disease. It is. I am not saying we shouldn’t screen for or treat breast cancer. We absolutely should. But let’s stop pretending that diagnosing and treating more women—especially when it may be unnecessary—is a sign of progress. If 20–30% of these women never needed treatment, but now live with lifelong consequences, we need to ask ourselves what we’re really celebrating.
The Hidden Costs: When Treatment Causes More Disease
Most women with breast cancer will not die from it. In fact, many are more likely to die from
heart disease, osteoporosis, or neurodegenerative conditions—risks that are often
amplified by breast cancer treatment.Cardiovascular Disease
Breast cancer treatments—including chemotherapy, radiation, and anti-hormonal therapy—increase the risk of cardiovascular disease. A study from the National Cancer Institute showed that women treated with anthracyclines or trastuzumab had significantly higher rates of heart failure and cardiomyopathy than women who did not receive chemotherapy. [2]
Let’s talk about aromatase inhibitors—now the standard of care for hormone-positive breast cancer in postmenopausal women.
Multiple studies show that AIs increase the risk of:
Heart failure by up to 86%
Cardiovascular death by 50%
Heart attacks and other cardiac events compared to tamoxifen [2,3]
And these are just the cardiac effects. We’re not telling women that these drugs will likely cause
crippling joint pain, hair thinning, dry skin, fatigue, depression, and painful sex. These life-altering side effects are rarely part of the conversation. It’s time they were.
Radiation therapy, especially on the left side, further increases cardiovascular risk by exposing the heart to radiation—raising long-term risks for coronary artery disease, cardiomyopathies, and arrhythmias.
Bone Health and Osteoporosis.
Aromatase inhibitors also dramatically reduce bone mineral density, increasing the risk for osteoporosis and fractures. The standard answer? Put women on bisphosphonates, which come with their own risks: osteonecrosis of the jaw, kidney dysfunction, and more. [4]
So now we’ve traded breast cancer for heart disease, fragile bones, and medication side effects that can be just as debilitating.
Cognitive Decline and Brain Health
Let’s not forget about the brain. “Chemo brain” is real. Many women experience memory loss, poor concentration, and mental fog during and after chemotherapy treatment.
And it’s not just chemo. We also see cognitive decline with aromatase inhibitors. Estrogen is essential for brain health. When we eliminate it, women pay the price—especially those already at risk for neurodegenerative diseases like Alzheimer’s. [5]
Quality of Life After Breast Cancer
Here’s what I hear from my patients—and what no one tells them to expect:
“I’m grateful to be alive... but I don’t feel like me anymore.”
Because it’s hard to feel grateful when:
- You can’t think clearly
- You can’t sleep
- You forget your words
- You’re tired, depressed, anxious
- You’ve gained weight and lost confidence
- Your breasts are deformed or gone alltogether
- Your joints ache, your hair is dry, and your skin is dull
- You have no libido, painful sex, and constant UTIs
This is the
real aftermath of breast cancer. And yet we continue to pat ourselves on the back for catching more “early-stage disease,” regardless of whether it ever needed treatment.
We have to do better.
ConclusionWe are not winning the war on breast cancer—we are redefining the battle to make it look like we are. By diagnosing more, we artificially lower mortality rates without reducing the number of deaths. We diagnose and then overtreat low-risk cancers, exposing women to therapies that cause lifelong damage. We praise the system for improving survival while ignoring the quality of that survival.
It's time to stop the illusion of progress. It’s time to be honest with women about what early detection and treatment really means—and start making decisions that prioritize not just longer life, but better life.
