Bette Davis: Understanding Breast Cancer

What was reported at the time

Bette Davis won two Academy Awards and was nominated ten times. UPI reported that she died on the night of Friday 6 October 1989, at the American Hospital in Neuilly, on the edge of Paris. She was 81. She had been returning from the San Sebastian festival in Spain when she became ill.

Deseret News, quoting her lawyer of 27 years, Harold Schiff, reported that she had a mastectomy about five years earlier. The same account described breast cancer, a stroke, and a broken hip coming in quick succession, followed by a return to work in 1985.

Schiff said the cancer had begun to spread about one to one and a half years before her death.

That sequence, a mastectomy, then years of other serious illness, then spread, then death, is a shape that a great many people live through. It is worth understanding on its own terms.

Cancer that comes back years later

Breast cancer treated successfully can return, and it can return long after treatment finishes.

NCI's survivorship guidance describes follow-up appointments where a doctor checks for recurrence. The checks it lists are a physical exam, a clinical breast exam, mammogram, breast MRI, a neurological exam, and a pelvic exam. Those are not one-off tests. They are a schedule.

The reason for the schedule is that some cells can survive treatment and stay quiet for years before growing again. That possibility is what recurrence means, and it is why "finished treatment" and "cured" are not the same sentence.

NCI also names the emotional side, and does so without minimizing it. It calls the anxiety that follow-up scans generate "scanxiety," and notes that people commonly fear any new pain is the cancer returning. Our page on survivorship covers what follow-up care involves.

What predicts a return

NCI lists what goes into a prognosis, and the list is longer than most people expect.

Personal factors come first: age, medical history, family history, menopausal status, and ethnicity. Then tumor factors: size, spread, grade, whether it carries estrogen or progesterone receptors, and whether it carries HER2.

Then response, meaning how the cancer behaved when treatment was given before surgery.

And then gene expression tests. NCI names OncotypeDX, MammaPrint, and the Breast Cancer Index. These read a panel of genes from the tumor and help predict the chance it spreads or returns after surgery.

NCI describes a prognostic stage that combines several of these at once. It is a different thing from anatomical stage, which is only about where the cancer has reached.

None of that existed in the mid-1980s. A tumor was measured and removed, and the follow-up was a physical exam and a mammogram. Our page on breast cancer covers how staging works now.

Age is the largest single risk factor

Davis was in her mid-seventies at the time of her mastectomy. That is not incidental.

NCI reports that cancer incidence rises above 1,000 cases per 100,000 people in age groups 60 and older. The median age at cancer diagnosis is 67. For breast cancer specifically it is 64.

That has a practical consequence that public conversation about breast cancer often skips. Most people diagnosed are old enough to have other conditions, and those conditions shape what treatment is possible.

A stroke and a broken hip, in the account of Davis's illness, are exactly that kind of complication. They affect mobility, recovery from anesthesia, tolerance of chemotherapy, and the ability to attend daily radiation. Deciding treatment in that setting is not about what is theoretically strongest. It is about what a specific body can take and what the person wants.

When to get checked

Two different lists matter here, and they apply to different people.

For anyone who has never had breast cancer, the changes to report are a lump in or near the breast or under the arm, a thickened area, a change in breast size or shape, nipple discharge that is not milk, a nipple that flattens or changes direction, and skin that dimples, puckers, reddens, darkens, scales, or swells.

For anyone treated for breast cancer in the past, the additions are about recurrence. New or persistent bone pain. Breathlessness that does not settle. Headache, seizure, or dizziness. Jaundice or swelling of the abdomen. A new lump on the chest wall or in the scar. Our page on cancer symptoms covers what makes a symptom worth investigating.

Follow-up appointments after breast cancer are not optional extras. They are the mechanism by which a recurrence gets found early rather than late.

The numbers, then and now

SEER puts five-year relative survival for female breast cancer at 91.9 percent across all stages, for cases from 2016 to 2022. In the same cohort it is 100.0 percent for localized disease, 87.5 percent for regional disease, and 33.8 percent for distant disease.

Those figures describe treatment available in the late 2010s and early 2020s. They do not describe the mid-1980s.

Everything that now shapes a treatment plan, receptor testing, HER2 status, gene expression scores, sentinel node biopsy, and the drugs that follow from each, arrived after Davis's operation.

What this story cannot tell you

The reports give a mastectomy, a rough interval, and a spread. They do not give a stage, a receptor status, a tumor grade, or a treatment plan, because none of that was published and much of it was not measurable then.

Her course therefore predicts nothing about anyone else's. A mastectomy in about 1984 followed by spread four or five years later is not a rule about how long anything takes.

What holds is smaller and more useful. Breast cancer can come back years after treatment. Follow-up exists precisely for that. And in older adults, the other conditions a person carries often matter as much as the tumor when deciding what to do.

Sources

• UPI Archives, Actress Bette Davis dies in Paris — https://www.upi.com/Archives/1989/10/07/Actress-Bette-Davis-dies-in-Paris/3865623736000/
• Deseret News, Bette Davis dies at 81 of cancer — https://www.deseret.com/1989/10/8/18827061/bette-davis-dies-at-81-of-cancer/
• NCI, Breast Cancer Survivorship — https://www.cancer.gov/types/breast/breast-cancer-survivorship
• NCI, Breast Cancer Prognosis and Survival Rates — https://www.cancer.gov/types/breast/survival
• NCI, Age and Cancer Risk — https://www.cancer.gov/about-cancer/causes-prevention/risk/age
• NCI, Breast Cancer Signs and Symptoms — https://www.cancer.gov/types/breast/symptoms
• SEER Cancer Stat Facts, Female Breast Cancer — https://seer.cancer.gov/statfacts/html/breast.html

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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