Breast Cancer Not the Knockout it Once Was as Medical Providers Continue the Battle

Every day, Holland Ouren takes her place on a battle line and prepares to go to war. The Texas-born, Arkansas-raised fighter steps to the front eagerly, champing at the bit to take another scalp against an enemy that threatens her community, her family and, but for a near miss, her own life, as well.

 

“I’m thrilled that I get to do this job. I even hate calling it a job,” she said. “I mean, it’s not like it’s all full of happy things, but I’m passionate about it, and every day I get to go in, it’s a good day.”

 

Ouren’s form of warfare does not require a rifle, fighter jet or drone strike except, perhaps, symbolically. A nurse practitioner at Highlands Oncology in Springdale, she approaches every day with a warrior’s mindset, fighting against an enemy that robs her patients of quality of life under the best circumstances and, at its worst, claims mothers, sisters, daughters and a growing number of men.

 

 

“When I got the call from Highlands to come and be their nurse practitioner, I just felt like it was my calling,” she said. “I know that might sound kind of goofy, but I just have always felt like this is my calling, doing this job. I love it. I love that I can actually help other women get through the process.”

 

It does not take much to see why Ouren feels that way about her role or why she is so good at it. Just like her patients and their families, the ongoing fight against cancer, especially breast cancer, is personal. When her mother was diagnosed, Ouren was her primary caregiver, and shortly after coming to Highlands Oncology, she herself joined the roster of millions of American women battling the disease.

 

“I was diagnosed at age 39, and it was caught super early,” said Ouren, 46. “I was in the middle of doing all the high-risk screenings at work when mine was caught by mammogram. I actually have a genetic mutation that predisposes me to breast cancer. I did a double mastectomy with reconstruction, and because it was caught so early, my treatment ended after surgery.

 

“I’m not diminishing what I went through, but what I went through was so much less than what a lot of our other breast cancer survivors have to go through. I was fortunate enough that we caught it so early, that it was treated with surgery and I didn’t have to go through chemo, which is a whole other battle in itself.”

 

 

Nearly from the birth of recorded medical history, cancer has been a scourge of humanity. The National Institutes of Health reveal the oldest known malignant tumor, evidence of aggressive bone cancer, dates back 1.7 million years, while mummified remains dated 3000 to 2,500 B.C. confirm malignant tumors of bone and multiple myeloma in ancient Egypt.

 

As OncoDaily reported, the Egyptians also provided the world with the oldest well-documented cases of breast cancer in humans, starting with the Edwin Smith Surgical Papyrus, fully translated in the 1930s and subsequently studied throughout the decades in multiple academic projects, one of the more recent using CT scans for examination without disturbing wrappings or remains in 2017.

 

The prognosis for breast cancer in the ancient world is, predictably, grim reading, but the passage of time made the condition no less agonizing for patients and their families. Fortunately, as Ouren’s story shows, modern medicine has advanced substantially over the years to provide more positive outcomes than ever before.

 

About 1 in 8 women in the U.S., or 13 percent, will develop breast cancer in their lifetime, the National Breast Cancer Foundation states. That translates to about 383,000 U.S. women receiving their diagnoses this year. Second only to skin cancer, breast cancer represents roughly 30 percent of all new female cancer diagnoses.

 

Also this year, the disease will claim about 42,000 lives nationwide. Breast cancer is the second leading cause of cancer death among U.S. women overall and the leading cause of death among Black and Hispanic women, per the Centers for Disease Control and Prevention.

 

While all of that is indeed sobering, the news is actually more hopeful when taken into historical context. According to figures by the National Cancer Institute, incidence rates held fairly steady between 102 and 110 per 100,000 women between 1975 and 1984 before spiking. After two years in the 124 to 127 per 100,000 range, the rates stayed above 131 per 100,000 for eight of the next 10 years, something analysts say reflects the improved screening protocols catching breast cancer that might have previously gone undetected. The rate peaked at 142 per 100,000 in 1999 before starting a slow but inexorable march downward.

 

In 2023, the latest data available, the CDC reported the incidence rate at 133 per 100,000. Arkansas stacks up very well on that measurement, data from the American Cancer Society shows. The Natural State’s incidence rate was pegged at 125 per 100,000, tied with Alabama for seventh-lowest among states and the District of Columbia, and alone in 24th place for breast cancer mortality.

 

In fact, the big takeaway among statistical trends is that breast cancer mortality in the U.S. was cut nearly in half between 1989 and 2024, Susan G. Komen states. Interestingly, between 1975 and 2025, white women had higher incidence than Black women, while Black women had a higher mortality rate than their white peers, according to Surveillance, Epidemiology and End Results Program data released in 2026, suggesting disparities in medical access and/or attitudes toward screenings.

 

Those differences aside, the fact remains that the overall five-year survival rate for breast cancer is 92 percent, nearly 20 percentage points higher than in 1975 and significantly higher than rates globally. Experts credit the improvement to various advancements in diagnosis and treatment, starting with screenings.

 

“This is my 14th year of practice, and I’ve really got to see the evolution in medical imaging,” said Dr. Stephen Routon, an imaging expert at Little Rock-based CARTI. “When I was in training, we were doing mammograms on film, where you’d print out a literal film. When I first started practicing, we started doing digital mammograms, where the image quality was better. Soon after, in my first year of practice, we saw a newer technology become available, tomosynthesis, commonly referred to as 3D mammograms.

 

 

“That was a complete game changer, especially for women with dense breast tissue or women that had had surgery and had a lot of scarring, but even for women that didn’t have dense tissue, I was able to see things that had never shown up before on mammograms. I will even say that in that first year, one of the first people I ever found a cancer on, it would have taken several years for this to show up on the old film mammogram.”

 

Routon said the technology has not stood still since; in fact, CARTI recently became the first medical institution in Arkansas to offer the next generation of imaging, known as contrast enhanced mammography.

 

 

“It’s a mammogram, but it utilizes intravenous contrast,” he said. “It’s a similar technique we use across medical imaging outside of the breast. Patients come in, and they’ll get an IV in their arm, and they’ll inject contrast, and it helps all throughout the body. Where it is new is in allowing us to do this in the breast. We’re excited about it because not everybody can get an MRI, and MRIs are more time-consuming and cumbersome, where this is a lot quicker and easier.”

 

Other advancements include genetics testing to help determine a person’s likelihood for developing cancers in the future, thereby affecting the number of people opting for preemptive surgical procedures up to and including mastectomies. According to surgeon Dr. Jennifer Porta of Highlands Oncology, that has enabled patients to make more timely and informed decisions.

 

 

“We’ve got different scoring methods that we can utilize that look at various things, like how many pregnancies a patient has had, what’s their family history, and now, with genetic testing becoming much more available, we’re able to help identify patients who might carry a gene that puts them at high risk for breast cancer,” she said.

 

“In those settings, we’re able to then be on top of that and say, ‘OK, we need to consider doing high-risk screening where we’re looking at doing mammogram and MRI every six months in those patients and able to detect breast cancer earlier in those settings.’ Sometimes we can even offer them medication to help reduce their risk of developing breast cancer or at least identify patients who would benefit from it.”

 

However, such resources do not come cheaply which presents many patients with hurdles in their ongoing care plans.

 

“With newer therapies, certainly, the cost of medications can be very expensive,” she said. “Fortunately, here at Highlands Oncology we have a fantastic pharmacy staff that is able to work with patients and work with drug companies. We’re always looking for ways to help provide patients with treatment options while minimizing the financial strain so that it’s not as much of a burden for them to be able to treat their cancer.”

 

Central to the process of a successful breast cancer strategy are the patients themselves and the degree to which they are willing to educate themselves and advocate for their care. Dr. Lingyi Chen at Genesis Cancer and Blood Institute said she has seen more patients taking the initiative to educate themselves about their condition and the fight that lies ahead of them.

 

 

“People are definitely more educated and more aware and knowledgeable,” she said. “With social media and the internet, there’s just a whole lot of information out there. That’s had a positive impact on their understanding of and on their compliance with therapy. Prior to all this information being out there, people might have had questions, might be concerned or have doubts, but nowadays, those doubts are fewer because of what they read.”

 

Another trend Chen has seen among patients is they are generally getting younger, meaning younger than 50 years of age, although she said she is not clear what is driving that.

 

“Across the board, you see more younger patients getting cancer,” she said. “I think some of that is hormone-related. Maybe it is something in the environment. Maybe it’s just earlier detection. Overall, we don’t know.

 

“I can say that I see more survival than I did when I was in my fellowship, and that’s probably related to women not waiting, not finding out later on in life but detecting earlier. We’re able to get them treatment that they can tolerate so that they can live longer.”

 

The outlook for breast cancer is even more encouraging, especially in Arkansas. The University of Arkansas for Medical Sciences in Little Rock formally applied for National Cancer Institute designation for its Winthrop P. Rockefeller Cancer Institute recently, something that holds great potential for the future of cancer treatment and research.

 

“A designated cancer institute designation says we’re looking at every aspect of cancer from how the translational cells can target metastasis, which means where to target cells so that people can survive,” said Dr. Ronda Henry-Tillman, professor of surgery and chief of breast surgical oncology at the institute. “Not every patient survives every disease, but knowing that we can study it at that level and it may lead to the most important part of treatment one day is very exciting.”

 

 

Henry-Tillman said being able to assist in the advancement of medications and medical technology combined with next-level medical school instruction will enable UAMS to produce physicians of exceptional skill who can not only save lives but preserve intact people going under the knife as part of their medical journey.

 

“Most women today are open to preserving their breasts, where 26 years ago, people just thought, ‘Oh, I’m just going to just have a radical mastectomy,’” she said. “At that time, we were moving away from doing anything radical, and now I train future physicians in an era where it’s expected that women have good outcomes. That means having cancer and you preserve the breast, or if you remove the breast, you get these amazing outcomes from taking tissue from other places and making breasts or designing your surgical treatment to give them what we call an oncoplastic outcome where the breast is reshaped or lifted.

 

“Breast cancer has advanced in every aspect, from how we biopsy, how we diagnose and how we treat, and treatment is not just surgical treatment but all aspects of the treatment, from chemo to radiation as needed. It is the combination of multispecialties coming together to provide the best cancer care possible at every level.”

 

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