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Estimating the incidence of breast cancer recurrence using administrative data

  • Epidemiology
  • Published:
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Abstract

Background

Breast cancer is the most common cancer among women, but most cancer registries do not capture recurrences. We estimated the incidence of local, regional, and distant recurrences using administrative data.

Methods

Patients diagnosed with stage I-III primary breast cancer in Ontario, Canada from 2013 to 2017 were included. Patients were followed until 31/Dec/2021, death, or a new primary cancer diagnosis. We used hospital administrative data (diagnostic and intervention codes) to identify local recurrence, regional recurrence, and distant metastasis after primary diagnosis. We used logistic regression to explore factors associated with developing a distant metastasis.

Results

With a median follow-up 67 months, 5,431/45,857 (11.8%) of patients developed a distant metastasis a median 23 (9, 42) months after diagnosis of the primary tumor. 1086 (2.4%) and 1069 (2.3%) patients developed an isolated regional or a local recurrence, respectively. Patients with distant metastatic disease had a median overall survival of 15.4 months (95% CI 14.4–16.4 months) from the time recurrence/metastasis was identified. In contrast, the median survival for all other patients was not reached. Patients were more likely to develop a distant metastasis if they had more advanced stage, greater comorbidity, and presented with symptoms (p < 0.0001). Trastuzumab halved the risk of recurrence [OR 0.53 (0.45–0.63), p < 0.0001].

Conclusion

Distant metastasis is not a rare outcome for patients diagnosed with breast cancer, translating to an annual incidence of 2132 new cases (17.8% of all breast cancer diagnoses). Overall survival remains high for patients with locoregional recurrences, but was poor following a diagnosis of a distant metastasis.

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Data availability

Ontario Health is prohibited from making the data used in this research publicly accessible if it includes potentially identifiable personal health information and/or personal information as defined in Ontario law, specifically the Personal Health Information Protection Act (PHIPA) and the Freedom of Information and Protection of Privacy Act (FIPPA). Upon request, data de-identified to a level suitable for public release may be provided.

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Acknowledgements

Parts of this material are based on data and information compiled and provided by the Canadian Institute of Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI. We acknowledge support of the Ministry of Health and Long-Term Care in this report. All views expressed are those of the authors of this report and do not necessarily reflect those of Ontario or the Ministry.

Funding

No specific funding sources were used.

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Author notes

  1. Andriana Barisic and Esha Homenauth contributed equally.

Authors and Affiliations

  1. Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada

    Steven Habbous, Andriana Barisic, Esha Homenauth, Sharmilaa Kandasamy, Katharina Forster, Andrea Eisen & Claire Holloway

  2. Department of Epidemiology & Biostatistics, Western University, London, ON, N6A 5C1, Canada

    Steven Habbous

  3. Department of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, M4Y 1H1, Canada

    Andrea Eisen

  4. Department of Surgery, University of Toronto, Toronto, ON, M5T1P5, Canada

    Claire Holloway

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  1. Steven Habbous
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Contributions

All authors contributed substantially to this work, including conception and study design (SH, KF, AE, CH, SK), analysis (SH, EH, AB), and manuscript preparation (all).

Corresponding author

Correspondence to Steven Habbous.

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All co-authors have no conflicts of interest to disclose.

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Research ethics was not required as per the Ontario Health privacy office.

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Patient consent was not required for this study.

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Habbous, S., Barisic, A., Homenauth, E. et al. Estimating the incidence of breast cancer recurrence using administrative data. Breast Cancer Res Treat 198, 509–522 (2023). https://doi.org/10.1007/s10549-022-06812-z

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