The online version of this article (doi:10.1186/1477-7819-10-108) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
TH conceived of the study, and drafted the manuscript. YN participated in the study and performed the statistical analysis. SM, SS, MT, YS, HS, MN, HU, TS and FT participated in the study and coordination. All authors read and approved the final manuscript.
The incidence of breast cancer has been increasing in Japan over the past three decades, and it is the currently the most common malignancy in Japan. This study investigated the temporal trends of the surgical outcomes in patients with breast cancer.
We evaluated 543 consecutive patients who underwent breast-cancer resection between 1980 and 2009. The temporal trends in the surgical outcome and clinicopathological features were evaluated separately for the periods covering 1980 to 1989, 1990 to 1999, and 2000 to 2009.
The number of patients who underwent resection during these three respective periods were 133, 176, and 234, respectively. All patients were women. The percentage of patients at stages 0 or 1 was 63.2%, 58.5%, and 43.6%, respectively, during the three periods. The mean diameter of tumors in each period was 38, 29, and 30 mm, respectively. The percentage of tumors with positive ER expression was 62.5%, 64.3%, and 69.7%, respectively. In terms of surgical procedures, the use of Halsted’s radical mastectomy decreased during each period: from 40.6% of cases to 8.5% and then to 0.4%, while the proportion of breast-conserving therapies increased, from 0% to 12.5%, and finally to 35.9%. The postoperative 10-year survival rates during the three periods were 75.9%, 83.5%, and 84.9%, respectively. The 10-year survival rates of patients with stage II disease during the three periods were 66.2%, 75.7%, and 90.7%, respectively. The prognosis of stage III disease in the three periods also showed a tendency toward improvement, increasing from 37.8% to 64.2%, and finally to 84.5%.
The survival of patients with stage II and III disease has improved during the past 30 years. Along with the recent advances in drug therapy, the surgical treatment has become less invasive, often because of drug therapy-related modifications.
Vrdoljak E, Wojtukiewicz MZ, Pienkowski T, Bodoky G, Berzinec P, Finek J, Todorović V, Borojević N, Croitoru A, South Eastern European Research Oncology Group: Cancer epidemiology in Central, South and Eastern European countries. Croat Med J. 2011, 52: 478-487. 10.3325/cmj.2011.52.478. PubMedCentralCrossRefPubMed
Matsuda T, Marugame T, Kamo K, Katanoda K, Ajiki W, Sobue T: Cancer incidence and incidence rates in Japan in 2005: based on data from 12 population-based cancer registries in the Monitoring of Cancer Incidence in Japan (MCIJ) project. Jpn J Clin Oncol. 2011, 41: 139-147. 10.1093/jjco/hyq169. CrossRefPubMed
Fisher B, Montague E, Redmond C, Deutsch M, Brown GR, Zauber A, Hanson WF, Wong A: Findings from NSABP Protocol No. B-04-comparison of radical mastectomy with alternative treatments for primary breast cancer. I. Radiation compliance and its relation to treatment outcome. Cancer. 1980, 46: 1-13. 10.1002/1097-0142(19800701)46:1<1::AID-CNCR2820460102>3.0.CO;2-3. CrossRefPubMed
Fisher B, Slack NH: Number of lymph nodes examined and the prognosis of breast carcinoma. Surg Gynecol Obstet. 1970, 131: 79-88. PubMed
Crump M, Sawka CA, DeBoer G, Buchanan RB, Ingle JN, Forbes J, Meakin JW, Shelley W, Pritchard KI: An individual patient-based meta-analysis of tamoxifen versus ovarian ablation as first-line endocrine therapy for premenopausal women with metastatic breast cancer. Breast Cancer Res Treat. 1997, 44: 201-210. 10.1023/A:1005833811584. CrossRefPubMed
Bonneterre J, Buzdar A, Nabholtz JM, Robertson JF, Thürlimann B, von Euler M, Sahmoud T, Webster A, Steinberg M, Arimidex Writing Committee, Investigators Committee Members: Anastrozole is superior to tamoxifen as first-line therapy in hormone receptor positive advanced breast carcinoma. Cancer. 2001, 92: 2247-2258. 10.1002/1097-0142(20011101)92:9<2247::AID-CNCR1570>3.0.CO;2-Y. CrossRefPubMed
Early Breast Cancer Trialists' Collaborative Group (EBCTCG): Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005, 365: 1687-1717. CrossRef
Shigematsu H, Kawaguchi H, Nakamura Y, Tanaka K, Shiotani S, Koga C, Nishimura S, Taguchi K, Nishiyama K, Ohno S: Significant survival improvement of patients with recurrent breast cancer in the periods 2001–2008 vs. 1992–2000. BMC Cancer. 2011, 11: 118-10.1186/1471-2407-11-118. PubMedCentralCrossRefPubMed
- Temporal trends in the surgical outcomes of patients with breast cancer
- BioMed Central
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