Silvia M Ess1, Christian Herrmann2, Christine Bouchardy3, Isabelle Neyroud4, Elisabetta Rapiti5, Isabelle Konzelmann6, Andrea Bordoni7, Laura Ortelli8, Sabine Rohrmann9, Harald Frick10, Mohsen Mousavi11, Beat Thürlimann12. 1. Cancer Registry St. Gallen-Appenzell, Cancer League Eastern Switzerland, St. Gallen, Krebsregister St.Gallen - Appenzell. Flurhofstr. 7, 9001 St. Gallen, Switzerland. Electronic address: Silvia.ess@kssg.ch. 2. Cancer Registry St. Gallen-Appenzell, Cancer League Eastern Switzerland, St. Gallen, Krebsregister St.Gallen - Appenzell. Flurhofstr. 7, 9001 St. Gallen, Switzerland; Swiss Tropical and Public Health Institute, Basel, Krebsregister St.Gallen - Appenzell. Flurhofstr. 7, 9001 St. Gallen, Switzerland. Electronic address: Christian.herrmann@kssg.ch. 3. Geneva Cancer Registry, University of Geneva, Magnin Registre genevois de tumeurs Rue Michel Servet 1, 1211 Geneve, Switzerland. Electronic address: Christine.BouchardyMagnin@unige.ch. 4. Geneva Cancer Registry, University of Geneva, Magnin Registre genevois de tumeurs Rue Michel Servet 1, 1211 Geneve, Switzerland. Electronic address: isabelle.neyroud-caspar@unige.ch. 5. Geneva Cancer Registry, University of Geneva, Magnin Registre genevois de tumeurs Rue Michel Servet 1, 1211 Geneve, Switzerland. Electronic address: Elisabetta.Rapiti@unige.ch. 6. Valais Cancer Registry, Observatoire valaisan de la santé, Sion, Registre valaisan de tumeurs, Avenue Grand-Champsec 64, 1950 Sion, Switzerland. Electronic address: isabelle.konzelmann@ovs.ch. 7. Valais Cancer Registry, Observatoire valaisan de la santé, Sion, Registre valaisan de tumeurs, Avenue Grand-Champsec 64, 1950 Sion, Switzerland. Electronic address: andrea.bordoni@ti.ch. 8. Ticino Cancer Registry, Registro tumori del Ticino Via in Selva 24, 6601, Locarno, Switzerland. Electronic address: laura.ortelli@ti.ch. 9. Cancer Registry of the Canton Zurich and Zug, University of Zurich, Krebsregister der Kantone Zürich und Zug Vogelsangstr. 10, 8091 Zürich, Switzerland. Electronic address: sabine.rohrmann@usz.ch. 10. Cancer Registry St. Gallen-Appenzell, Cancer League Eastern Switzerland, St. Gallen, Krebsregister St.Gallen - Appenzell. Flurhofstr. 7, 9001 St. Gallen, Switzerland; Institute for Pathology, Kantonsspital St. Gallen, Institut für Pathologie. Rorschacher Strasse 95, 9007 St.Gallen, Switzerland. Electronic address: Harald.Frick@kssg.ch. 11. Cancer Registry St. Gallen-Appenzell, Cancer League Eastern Switzerland, St. Gallen, Krebsregister St.Gallen - Appenzell. Flurhofstr. 7, 9001 St. Gallen, Switzerland. Electronic address: Mohsen.Mousavi@kssg.ch. 12. Breast Cancer Centre, Kantonsspital St. Gallen, Brustzentrum St. Gallen. Rorschacher Strasse 95, 9007 St.Gallen, Switzerland. Electronic address: beat.thuerlimann@kssg.ch.
Abstract
OBJECTIVE: To study the impact of subtypes and comorbidities on breast cancer (BC) relapse and survival in the heterogeneous patients of the real world. METHODS: We identified patients diagnosed with BC between January 2003 and December 2005 from six population-based Swiss cancer registries. Clinicopathologic data was completed with information on locoregional and distant relapse and date and cause of death for over 10-years. We approximated BC subtypes using grade and the immunohistochemical panel for oestrogen, progesterone and human epidermal growth factor 2 (HER2) receptor status. We studied factors affecting relapse and survival. RESULTS: Luminal A-like subtype represented 46% of all newly diagnosed BC (N = 1831), followed by luminal B-like (N = 1504, 38%), triple negative (N = 436, 11%) and HER2 enriched (N = 204, 5%). We observed regional disparities in subtype prevalence that contribute to explain regional differences in survival formerly described. Disease relapse and BC specific mortality differed by subtype and were lower for luminal A like tumours than for other subtypes for any stage at diagnosis. After a median follow-up of 10.9 years, 1311 (33%) had died, half of them 647 (16%) due to another disease, showing the importance of comorbidities. Omission of systemic therapies in selected patients was not associated with poorer BC specific survival, BC subtype and life expectancy playing a role. CONCLUSIONS: Information on tumour subtype is necessary for an adequate interpretation of population-based BC studies. Measures of comorbidity or frailty help in the evaluation of quality of care in the highly heterogeneous patients of the real world.
OBJECTIVE: To study the impact of subtypes and comorbidities on breast cancer (BC) relapse and survival in the heterogeneous patients of the real world. METHODS: We identified patients diagnosed with BC between January 2003 and December 2005 from six population-based Swiss cancer registries. Clinicopathologic data was completed with information on locoregional and distant relapse and date and cause of death for over 10-years. We approximated BC subtypes using grade and the immunohistochemical panel for oestrogen, progesterone and human epidermal growth factor 2 (HER2) receptor status. We studied factors affecting relapse and survival. RESULTS: Luminal A-like subtype represented 46% of all newly diagnosed BC (N = 1831), followed by luminal B-like (N = 1504, 38%), triple negative (N = 436, 11%) and HER2 enriched (N = 204, 5%). We observed regional disparities in subtype prevalence that contribute to explain regional differences in survival formerly described. Disease relapse and BC specific mortality differed by subtype and were lower for luminal A like tumours than for other subtypes for any stage at diagnosis. After a median follow-up of 10.9 years, 1311 (33%) had died, half of them 647 (16%) due to another disease, showing the importance of comorbidities. Omission of systemic therapies in selected patients was not associated with poorer BC specific survival, BC subtype and life expectancy playing a role. CONCLUSIONS: Information on tumour subtype is necessary for an adequate interpretation of population-based BC studies. Measures of comorbidity or frailty help in the evaluation of quality of care in the highly heterogeneous patients of the real world.
Authors: Hege Russnes; Giske Ursin; Anna L V Johansson; Cassia B Trewin; Irma Fredriksson; Kristin V Reinertsen Journal: Breast Cancer Res Date: 2021-02-01 Impact factor: 6.466
Authors: Dinja T Kruger; Mark Opdam; Joyce Sanders; Vincent van der Noort; Epie Boven; Sabine C Linn Journal: APMIS Date: 2020-02-27 Impact factor: 3.205