Relapse Rate for Breast Cancer Markedly Reduced Since 1980s: Presented at SABCS
By Alex Morrisson
SAN ANTONIO -- December 13, 2011 -- Major changes in the treatment of women with stage I to III breast cancer in the Netherlands has resulted in a decrease of relapse rates by more than 50%, researchers reported here at the 34th Annual San Antonio Breast Cancer Symposium (SABCS).
“It is quite obvious that changes in treatment strategies have resulted in far fewer women suffering relapses,” said Sandra Geurts, PhD, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, at her poster presentation on December 8.
Dr. Geurts and colleagues reviewed data involving 307 women treated for breast cancer between 1972 to 1986 at St. Anna Hospital, Oss, the Netherlands. The relapse rate for these women was of 37%, compared with a relapse rate of 16% among women 8,570 women treated at 53 hospitals in the Netherlands between 2003 and 2004 (data taken from the Netherlands Cancer Registry). This translated to a 50% reduction in the relative risk of experienced relapse (P <.05).
“What we are seeing is that the earlier treatment, mammograms, and new medical therapies are working to reduce breast cancer relapse,” Dr. Geurts said.
The study indicated that breast-conserving therapy has also increased dramatically, from about 20% in the earlier group of patients to more than 50% in the later group of patients.
Reflecting evidence-based medicine, radiation therapy after lumpectomy was given to more than 905 of women in both eras. However radiation following mastectomy -- given to 70% of women in the earlier treatment group -- was reduced to about 30% in the 2000s.
The use of chemotherapy increased in 2003/2004 to about 35% of women; compared with chemotherapy use prescribed to about 15% of women in the 20th Century. Hormonal therapy was given to more than 40% of women in 2003/2004 compared with less than 5% of women in the 1972-1986 period.
Dr. Geurts noted that other changes in management of patients have contributed to better outcomes for women. In particular, she noted that the importance of resection margins in breast-conserving therapy and changed chemotherapeutic options have resulted in more effective treatment.
Median age at diagnosis between 1972 to 1986 was 53 years, compared with 58 years between 2003 and 2004. By 2003/2004, about 58% of women were being diagnosed with T1 tumours compared with 43% of women in the 1972 to 1986 period.
Nodal shift also occurred, Dr. Geurts said. Between 1972 and 1986, about 12% of women had N3 disease, compared with 4% in 2003/2004. She said that was due to increased lymph node staging and use of sentinel node procedures.
[Presentation title: Huge Improvement in Relapse-Free Breast Cancer Survival Over the Last 25 Years. Abstract P1-08-03]
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