B Cutuli1, F Dalenc2, P-H Cottu3, J Gligorov4, J-P Guastalla5, T Petit6, A Amrate7. 1. Department of Oncology and Radiotherapy, institut du cancer Courlancy, 38, rue de Courlancy, 51100 Reims, France. Electronic address: bcutuli@iccreims.fr. 2. Institut Claudius-Regaud, 33000 Toulouse, France. 3. Institut Curie, 75005 Paris, France. 4. Hôpital Tenon, 75020 Paris, France. 5. Centre Léon-Bérard, 69008 Lyon, France. 6. Centre Paul-Strauss, 67000 Strasbourg, France. 7. AstraZeneca, 92500 Rueil-Malmaison, France.
Abstract
PURPOSE: Several studies showed a breast cancer downstaging due to screening. A first national survey was conducted in France in 2001-2002 to evaluate in the current clinical practice the clinicopathological features and treatments of 1049 firstly operated breast cancers. In order to assess the impact of the national screening program implemented in all regions in France in 2004, a new survey was performed in 2007-2008. MATERIAL: The new survey included 1433 firstly operated breast cancers prospectively collected. These new data were compared to the results of the first national survey. RESULTS: According to TN classification, we found in the second survey T0: 27.6%, T1: 48.6%, T2: 21.3%, T3T4: 3.8% and Tx: 0.7%. Infiltrating ductal and lobular carcinomas represented 80% and 13% of tumours. Hormone receptors were positive in 85.3% and Her-2 overexpressed in 12.4% of tumours (83.9% and 20.6% in the first survey); 68.2% and 32% were pN0 and pN1-3. Lumpectomy and mastectomy were performed in 77% and 23% of the cases. Axillary dissection, sentinel node biopsy or both were performed in 42.6%, 41% and 16.4% of the cases, respectively. Radiotherapy, chemotherapy, hormonotherapy and trastuzumab were given to 93%, 51%, 83% and 9.3% of the patients. Compared with the results from the first survey, we found an increase of infraclinical lesions (T0 from 8.4 to 27.6%) and a wide decrease of pN+ rate (from 44% to 32%). The mastectomy rate was constant (23%), as well as radiotherapy use, whereas chemotherapy use decreased from 62.8 to 55.6%. CONCLUSION: A complete national screening coverage clearly provides a favourable modification of breast cancer clinicopathological features. Both locoregional and adjuvant treatments were greatly downscaled.
PURPOSE: Several studies showed a breast cancer downstaging due to screening. A first national survey was conducted in France in 2001-2002 to evaluate in the current clinical practice the clinicopathological features and treatments of 1049 firstly operated breast cancers. In order to assess the impact of the national screening program implemented in all regions in France in 2004, a new survey was performed in 2007-2008. MATERIAL: The new survey included 1433 firstly operated breast cancers prospectively collected. These new data were compared to the results of the first national survey. RESULTS: According to TN classification, we found in the second survey T0: 27.6%, T1: 48.6%, T2: 21.3%, T3T4: 3.8% and Tx: 0.7%. Infiltrating ductal and lobular carcinomas represented 80% and 13% of tumours. Hormone receptors were positive in 85.3% and Her-2 overexpressed in 12.4% of tumours (83.9% and 20.6% in the first survey); 68.2% and 32% were pN0 and pN1-3. Lumpectomy and mastectomy were performed in 77% and 23% of the cases. Axillary dissection, sentinel node biopsy or both were performed in 42.6%, 41% and 16.4% of the cases, respectively. Radiotherapy, chemotherapy, hormonotherapy and trastuzumab were given to 93%, 51%, 83% and 9.3% of the patients. Compared with the results from the first survey, we found an increase of infraclinical lesions (T0 from 8.4 to 27.6%) and a wide decrease of pN+ rate (from 44% to 32%). The mastectomy rate was constant (23%), as well as radiotherapy use, whereas chemotherapy use decreased from 62.8 to 55.6%. CONCLUSION: A complete national screening coverage clearly provides a favourable modification of breast cancer clinicopathological features. Both locoregional and adjuvant treatments were greatly downscaled.
Authors: Francesco Sardanelli; Hildegunn S Aase; Marina Álvarez; Edward Azavedo; Henk J Baarslag; Corinne Balleyguier; Pascal A Baltzer; Vanesa Beslagic; Ulrich Bick; Dragana Bogdanovic-Stojanovic; Ruta Briediene; Boris Brkljacic; Julia Camps Herrero; Catherine Colin; Eleanor Cornford; Jan Danes; Gérard de Geer; Gul Esen; Andrew Evans; Michael H Fuchsjaeger; Fiona J Gilbert; Oswald Graf; Gormlaith Hargaden; Thomas H Helbich; Sylvia H Heywang-Köbrunner; Valentin Ivanov; Ásbjörn Jónsson; Christiane K Kuhl; Eugenia C Lisencu; Elzbieta Luczynska; Ritse M Mann; Jose C Marques; Laura Martincich; Margarete Mortier; Markus Müller-Schimpfle; Katalin Ormandi; Pietro Panizza; Federica Pediconi; Ruud M Pijnappel; Katja Pinker; Tarja Rissanen; Natalia Rotaru; Gianni Saguatti; Tamar Sella; Jana Slobodníková; Maret Talk; Patrice Taourel; Rubina M Trimboli; Ilse Vejborg; Athina Vourtsis; Gabor Forrai Journal: Eur Radiol Date: 2016-11-02 Impact factor: 5.315