Medical Research: What is the background for this study?
Medical Research: Why is this study important?
Response: This prospective nationwide study investigates whether tumor stage (size and axillary nodal involvement) still has impact on survival of breast cancer in modern times with more effective end more widely used additional systemic therapy . We take tumour biology, age and the different therapies into account and compare results with our nationwide results from 1999-2005.
- Mortality increased with increasing tumour size and independently with nodal involvement, correcting for age, tumour biology and therapy.
- Five year relative survival (this is compared with women without breast cancer of the same ages) was 96% for all 93.569 Dutch breast cancer patients between 2006-2012 and 100% in cancers ≤ 1cm.3. In 2006-2012 in the Dutch population 65% of the breast cancers were detected ≤2cm.
Medical Research: What should clinicians and patients take away from your report?
- First, the general prospect of a woman diagnosed with breast cancer currently in the Western world is very good.
- Catching breast cancer early is still highly important.
- Surgery is the cornerstone of therapy and maybe breast conserving therapy is even a bit better for survival than mastectomy and certainly not worse. Breast cancer in the other breast did not impact on survival and preventive contralateral mastectomy seems only well advised in high risk gene mutation carriers.
- Both additional hormonal therapy and targeted therapy (usual against epidermal growth factor her2neu) are, if indicated by tumour stage and receptor status, beneficial for survival.
- Further also patients diagnosed late with large tumors of 5cm and above experienced an improvement in outcome. In the earlier group such patients had a 70% five-year relative survival, while in the recent cohort this increased to 81%. This may be a comforting result for some patients.
- Finally our results are informative when considering breast screening.
Medical Research: What database did you use in this study?
Response: The Netherlands Cancer Registry is a nationwide prospective population-based cancer registry in which all newly pathologically confirmed malignancies in the Netherlands are recorded. Characteristics of the cancer, treatment and vital data of the patient are registered. Using data from the Netherlands Cancer Registry we compared overall survival of almost 174,000 female breast cancer patients from two time frames 1999 through 2005 and 2006 through 2012.
Saadatmand Sepideh, Bretveld Reini, SieslingSabine, Tilanus-Linthorst Madeleine M A. Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173 797 patients 2015; 351 :h4901
Dr. Madeleine M A Tilanus-Linthorst PhD (2015). Catching Breast Cancer Early Is Still Critical