A study of tumour sizes has emphasised the importance of catching breast cancer at an early stage, researchers say today.
The rate of survival from breast cancer falls with increasing tumour size and number of positive lymph nodes at detection of breast cancer, say Dr Madeleine Tilanus-Linthorst and her team at Erasmus University, Rotterdam, Netherlands, in The BMJ.
Therapies have improved significantly since 2004, they write, however, "data on these prognostic factors in patient cohorts after 2004 are scarce." So the team carried out a nationwide study using figures on 173,797 female breast cancer patients from the Netherlands’ Cancer Registry.
Compared with patients from 1999-2005, patients from 2006-12 had significantly smaller tumours that were more often lymph node negative. This group received more chemotherapy, hormonal therapy, and targeted therapy. The five year survival rate in patients from 2006-12 was 96%.
Mortality risk was decreased by surgery (especially breast conserving), radiotherapy, and systemic therapies, the researchers report. Mortality risk was higher in both time groups for those with larger tumours.
"Tumour stage at diagnosis of breast cancer still influences overall survival significantly in the current era of effective systemic therapy," they conclude.
Dr Tilanus-Linthorst said last night: "The general prospect of a woman diagnosed with breast cancer currently in the Western world is very good, but catching breast cancer early is highly important."
She added: "Surgery is crucial and maybe breast conserving therapy is even a bit better for survival than mastectomy and certainly not worse.
"Both additional hormonal therapy and targeted therapy add, if indicated by tumour stage and receptor status, to survival.
"Together with surgery, radiotherapy and to some degree chemotherapy, they have improved survival considerably in later stage disease – five year relative survival improved from 70% between 1999-2005 to 81% in 2006-2012 in tumours greater than 5cm."
Saadatmand, S. et al. Influence of tumour stage at breast cancer detection on survival in modern times: population based study in 173797 patients. BMJ 7 October 2015; doi: 10.1136/bmj.h4901 [abstract]
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