Skip to main content
Log in

Trends in breast-conserving surgery in Denmark, 1982–2002

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript


Using hospital discharge data from the counties in Northern Denmark and the Danish Cancer Registry, we examined the trend in the prevalence of breast-conserving surgery (BCS) to treat primary breast cancer from 1982 through 2002, with an emphasis on publications that may have influenced surgical practice in Denmark. Overall, the prevalence of BCS increased from less than 1% of breast cancer operations in 1982 to approximately 25% by 2002. The rise in prevalence was most pronounced for the treatment of young women and women with early-stage breast cancer. Of three pivotal clinical trials, the most significant trigger of the upward trend appeared to be a study conducted by the Danish Breast Cancer Cooperative Group, published in 1988. After 1988, there was a steep rise in the prevalence of BCS. By 2002, BCS prevalence appeared to reach a threshold at 25% of breast cancer operations, seemingly defined by the proportion of new breast cancer cases who are good candidates for BCS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others



Breast-conserving surgery


Breast-conserving surgery with radiotherapy


Civil personal registration number


Danish Breast Cancer Cooperative Group


Danish cancer registry


Hospital discharge registry


International Classification of Diseases


National Surgical Adjuvant Breast and Bowel Project


Surveillance, epidemiology and end results


International Union Against Cancer


  1. Veronesi U, Zurrida S. Breast cancer surgery: a century after Halsted. J Cancer Res Clin Oncol 1996;122(2):74–7.

    Article  PubMed  CAS  Google Scholar 

  2. Crile G Jr, Hoerr SO. Results of treatment of carcinoma of the breast by local excision. Surg Gynecol Obstet 1971;132(5):780–2.

    PubMed  Google Scholar 

  3. Mustakallio S. Conservative treatment of breast carcinoma–review of 25 years follow up. Clin Radiol 1972;23(1):110–6.

    Article  PubMed  CAS  Google Scholar 

  4. Atkins H, Hayward JL, Klugman DJ, Wayte AB. Treatment of early breast cancer: a report after ten years of a clinical trial. Br Med J 1972;2(5811):423–9.

    Article  PubMed  CAS  Google Scholar 

  5. Blichert-Toft M, Brincker H, Andersen JA, Andersen KW, Axelsson CK, Mouridsen HT, et al. A Danish randomized trial comparing breast-preserving therapy with mastectomy in mammary carcinoma. Preliminary results. Acta Oncol 1988;27(6A):671–7.

    PubMed  CAS  Google Scholar 

  6. Fisher B, Bauer M, Margolese R, Poisson R, Pilch Y, Redmond C, et al. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med 1985;312(11):665–73.

    Article  PubMed  CAS  Google Scholar 

  7. Veronesi U, Saccozzi R, Del Vecchio M, Banfi A, Clemente C, De Lena M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med 1981;305(1):6–11.

    Article  PubMed  CAS  Google Scholar 

  8. van Dongen JA, Bartelink H, Fentiman IS, Lerut T, Mignolet F, Olthuis G, et al. Randomized clinical trial to assess the value of breast-conserving therapy in stage I and II breast cancer, EORTC 10801 trial. J Natl Cancer Inst Monogr 1992(11):15–8.

  9. Blichert-Toft M, Rose C, Andersen JA, Overgaard M, Axelsson CK, Andersen KW, et al. Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis. Danish Breast Cancer Cooperative Group. J Natl Cancer Inst Monogr 1992(11):19–25.

    Google Scholar 

  10. Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1995;333(22):1456–61.

    Article  PubMed  CAS  Google Scholar 

  11. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347(16):1233–41.

    Article  PubMed  Google Scholar 

  12. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002;347(16):1227–32.

    Article  PubMed  Google Scholar 

  13. van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 2000;92(14):1143–50.

    Article  PubMed  Google Scholar 

  14. Greenland S. Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology 1995;6(4):356–65.

    Article  PubMed  CAS  Google Scholar 

  15. Christensen LH, Engholm G, Cortes R, Ceberg J, Tange U, Andersson M, et al. Reduced mortality for women with mammography-detected breast cancer in east Denmark and south Sweden. Eur J Cancer 2006;42(16):2773–80.

    Article  PubMed  CAS  Google Scholar 

  16. Lindqvist R, Moller TR, Stenbeck M, Diderichsen F. Do changes in surgical procedures for breast cancer have consequences for hospital mean length of stay? A study of women operated on for breast cancer in Sweden, 1980-95. Int J Technol Assess Health Care 2002;18(3):566–75.

    PubMed  Google Scholar 

  17. Singh G, Miller B, Hankey B, Edwards B. Area Socioeconomic Variations in U.S. Cancer Incidence, Mortality, Stage, Treatment, and Survival, 1975–1999. NCI Cancer Surveillance Monograph Series, Number 4, 2003.

  18. Andersen KW, Mouridsen HT. Danish Breast Cancer Cooperative Group (DBCG). A description of the register of the nation-wide programme for primary breast cancer. Acta Oncol 1988;27(6A):627–47.

    Article  PubMed  CAS  Google Scholar 

Download references


Conflicts of interest: The authors report no conflicts of interest. Sources of support: The Karen Elise Jensen Foundation and R01 CA118708-01A1 provided partial funding support for this study.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Thomas P. Ahern.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ahern, T.P., Larsson, H., Garne, J.P. et al. Trends in breast-conserving surgery in Denmark, 1982–2002. Eur J Epidemiol 23, 109–114 (2008).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: