Bent Ejlertsen1,2, Birgitte Vrou Offersen3,4, Jens Overgaard4, Peer Christiansen5, Maj-Britt Jensen1, Niels Kroman6, Ann Søgaard Knoop2, Henning Mouridsen1. 1. a Danish Breast Cancer Cooperative Group (DBCG) Secretariat and Statistical Office, Rigshospitalet , Copenhagen University Hospital , Copenhagen , Denmark. 2. b Department of Oncology , Copenhagen University Rigshospitalet , Copenhagen , Denmark. 3. c Department of Oncology , Aarhus University Hospital , Aarhus , Denmark. 4. d Department of Experimental Clinical Oncology , Aarhus University Hospital , Aarhus , Denmark. 5. e Department of Breast Surgery , Aarhus University Hospital , Aarhus , Denmark. 6. f Department of Breast Surgery , Copenhagen University Rigshospitalet , Copenhagen , Denmark.
Abstract
BACKGROUND: Over the past 40 years the Danish Breast Cancer Cooperative Group (DBCG) has made significant contributions to improve outcome and to make treatment of patients with early breast cancer more tolerable through nationwide and international trials evaluating loco-regional and systemic treatments. These trials have been instrumental to establish standards for the treatment of early breast cancer. METHODS: The DBCG 82 trials had a global impact by documenting that the significant gain in loco-regional recurrence from postmastectomy radiation added to systemic therapy was associated with a reduction in distant recurrence and mortality in high-risk pre- and postmenopausal patients. The DBCG trials comparing breast conserving surgery and radiotherapy with mastectomy and more recently the trial of internal mammary node irradiation also had a major impact of practice. The trials initiated by the DBCG 40 years ago on tamoxifen and cyclophosphamide based chemotherapy became instrumental for the development of adjuvant systemic therapy not only due to their positive results but by sharing these important data with other members of the Early Breast Cancer Trialist' Collaborative Group (EBCTCG). Trials from the DBCG have also been important for highlighting the relative importance of anthracyclines and taxanes in the adjuvant setting. Furthermore, DBCG has made a major contribution to the development of aromatase inhibitors and targeted adjuvant treatment for human epidermal growth factor receptor 2 positive breast cancers. RESULTS: The substantial impact of these treatment improvements is illustrated by a 46.7% 10-year overall survival of early breast cancer patients treated in 1978-1987 compared to 71.5% for patients treated 2008-2012. CONCLUSIONS: The trials conducted and implemented by the DBCG appear to have a major impact on the substantial survival improvements in breast cancer.
BACKGROUND: Over the past 40 years the Danish Breast Cancer Cooperative Group (DBCG) has made significant contributions to improve outcome and to make treatment of patients with early breast cancer more tolerable through nationwide and international trials evaluating loco-regional and systemic treatments. These trials have been instrumental to establish standards for the treatment of early breast cancer. METHODS: The DBCG 82 trials had a global impact by documenting that the significant gain in loco-regional recurrence from postmastectomy radiation added to systemic therapy was associated with a reduction in distant recurrence and mortality in high-risk pre- and postmenopausal patients. The DBCG trials comparing breast conserving surgery and radiotherapy with mastectomy and more recently the trial of internal mammary node irradiation also had a major impact of practice. The trials initiated by the DBCG 40 years ago on tamoxifen and cyclophosphamide based chemotherapy became instrumental for the development of adjuvant systemic therapy not only due to their positive results but by sharing these important data with other members of the Early Breast Cancer Trialist' Collaborative Group (EBCTCG). Trials from the DBCG have also been important for highlighting the relative importance of anthracyclines and taxanes in the adjuvant setting. Furthermore, DBCG has made a major contribution to the development of aromatase inhibitors and targeted adjuvant treatment for humanepidermal growth factor receptor 2 positive breast cancers. RESULTS: The substantial impact of these treatment improvements is illustrated by a 46.7% 10-year overall survival of early breast cancerpatients treated in 1978-1987 compared to 71.5% for patients treated 2008-2012. CONCLUSIONS: The trials conducted and implemented by the DBCG appear to have a major impact on the substantial survival improvements in breast cancer.
Authors: Lindsay J Collin; Deirdre P Cronin-Fenton; Thomas P Ahern; Kristina B Christensen; Per Damkier; Stephen Hamilton-Dutoit; Anders Kjaersgaard; Kristina L Lauridsen; Rami Yacoub; Peer Christiansen; Henrik Toft Sørensen; Timothy L Lash Journal: Acta Oncol Date: 2018-10-23 Impact factor: 4.089
Authors: Lindsay J Collin; Sinna P Ulrichsen; Thomas P Ahern; Michael Goodman; Lauren E McCullough; Lance A Waller; Kristina Bang Christensen; Per Damkier; Stephen Hamilton-Dutoit; Kristina L Lauridsen; Rami Yacoub; Peer M Christiansen; Bent Ejlertsen; Henrik Toft Sørensen; Deirdre P Cronin-Fenton; Timothy L Lash Journal: Acta Oncol Date: 2019-10-31 Impact factor: 4.089