Ashley Davidson1, Stephen Chia2, Robert Olson3, Alan Nichol4, Caroline Speers5, Andy J Coldman6, Chris Bajdik7, Ryan Woods5, Scott Tyldesley8. 1. Department of Medical Oncology, Fraser Valley Centre, British Columbia Cancer Agency, Vancouver, BC. 2. Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC ; Department of Medical Oncology, Vancouver Centre, British Columbia Cancer Agency, Vancouver, BC. 3. Department of Radiation Oncology, Centre for the North, British Columbia Cancer Agency, Vancouver, BC. 4. Department of Radiation Oncology, Vancouver Centre, British Columbia Cancer Agency, Vancouver, BC. 5. Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC. 6. Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, BC. 7. British Columbia Research Centre, British Columbia Cancer Agency, Vancouver, BC. 8. Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC ; Department of Radiation Oncology, Vancouver Centre, British Columbia Cancer Agency, Vancouver, BC.
Abstract
BACKGROUND: There are very few long-term Canadian data on breast cancer outcomes by stage. We described the stage, treatment and outcomes of breast cancer at a population level for patients in British Columbia. METHODS: This population-based cohort study included almost all patients with incident breast cancer registered in 2002 (about 97.6% registry case completeness). For these patients, information on stage, primary local surgery, radiotherapy, chemotherapy, hormone therapy and survival outcome (based on registry date and cause-of-death data) were available. We calculated Kaplan-Meier curves for breast cancer-specific survival and overall survival by stage and analyzed prognostic and treatment factors with a multivariable Cox model. RESULTS: The 2927 incident cases of breast cancer identified in 2002 had the following distribution by stage: stage 0 (in situ), 424 (14%); stage I, 1118 (38%); stage II, 938 (32%); stage III, 233 (8%); stage IV, 123 (4%); unknown, 91 (3%). The distribution of patients' ages was < 40 years, 127 (4%); 40-49, 538 (18%); 50-59, 719 (25%); 60-69, 660 (23%); 70-79, 583 (20%); ≥ 80, 300 (10%). Within the first year after diagnosis, radiotherapy was provided to 1649 patients (56%), chemotherapy to 928 (32%) and hormone therapy to 1664 (57%). Ten-year breast cancer-specific survival rates by stage were > 99% for stage 0, 95% for stage I, 81% for stage II, 55% for stage III and 4% for stage IV. Ten-year overall survival rates were 89% for stage 0, 81% for stage I, 68% for stage II, 43% for stage III and 2% for stage IV. INTERPRETATION: This analysis provides a Canadian benchmark for treatment rates and 10-year outcomes by stage for all incident cases of breast cancer in a single province. Outcomes in British Columbia compared well with published rates for the United States and Europe.
BACKGROUND: There are very few long-term Canadian data on breast cancer outcomes by stage. We described the stage, treatment and outcomes of breast cancer at a population level for patients in British Columbia. METHODS: This population-based cohort study included almost all patients with incident breast cancer registered in 2002 (about 97.6% registry case completeness). For these patients, information on stage, primary local surgery, radiotherapy, chemotherapy, hormone therapy and survival outcome (based on registry date and cause-of-death data) were available. We calculated Kaplan-Meier curves for breast cancer-specific survival and overall survival by stage and analyzed prognostic and treatment factors with a multivariable Cox model. RESULTS: The 2927 incident cases of breast cancer identified in 2002 had the following distribution by stage: stage 0 (in situ), 424 (14%); stage I, 1118 (38%); stage II, 938 (32%); stage III, 233 (8%); stage IV, 123 (4%); unknown, 91 (3%). The distribution of patients' ages was < 40 years, 127 (4%); 40-49, 538 (18%); 50-59, 719 (25%); 60-69, 660 (23%); 70-79, 583 (20%); ≥ 80, 300 (10%). Within the first year after diagnosis, radiotherapy was provided to 1649 patients (56%), chemotherapy to 928 (32%) and hormone therapy to 1664 (57%). Ten-year breast cancer-specific survival rates by stage were > 99% for stage 0, 95% for stage I, 81% for stage II, 55% for stage III and 4% for stage IV. Ten-year overall survival rates were 89% for stage 0, 81% for stage I, 68% for stage II, 43% for stage III and 2% for stage IV. INTERPRETATION: This analysis provides a Canadian benchmark for treatment rates and 10-year outcomes by stage for all incident cases of breast cancer in a single province. Outcomes in British Columbia compared well with published rates for the United States and Europe.
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