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Clinical and Translational Oncology

, Volume 17, Issue 4, pp 296–305 | Cite as

A study comparing two consecutive historical periods in breast cancer with a focus on surgical treatment, loco-regional recurrence, distant metastases and mortality

  • A. García-FernándezEmail author
  • C. Chabrera
  • M. García-Font
  • M. Fraile
  • I. Barco
  • S. González
  • L. Cirera
  • J. M. Lain
  • C. González
  • E. Veloso
  • L. Codina
  • M. Piqueras
  • A. Pessarrodona
  • N. Gimenez
Research Article

Abstract

Background and aim

Recent introduction of breast units, mass-screening programmes (SP) and sentinel node biopsy (SNB) has impacted on the clinical care of breast cancer patients (BC), resulting in a significant increase of breast-conserving surgery with the goal of achieving completely free margins and good cosmetic outcome, along with significantly less axillary morbidity. In order to ascertain the combined impact of SP and SNB on BC patients, we have reviewed the primary therapeutic approach of patients diagnosed with invasive breast carcinoma in our centre, both before and after implementation of the two new procedures.

Methods

1,942 patients operated for BC between 1997 and 2013 in two clinical centres. Two historical periods were considered: before and after the advent of the Breast Unit in our institutions and the concurrent implementation of SP and SNB (September 2002).

Results

Rates of breast-conserving surgery and re-operations improved in the second period. Intraoperative margin re-excision increased in the second period. Breast-conserving surgery decreased in parallel to stage: from 79 % for stage I to 31 % for stage III. The Cox analysis, including stage as adjusted for all significant variables, showed statistically significant differences in favour of the initial stages but only for specific mortality, not overall mortality.

Conclusions

Combined implementation of breast units, SP, and SNB have resulted in a significant improvement of BC treatment leading to increased rates of breast-conserving surgery and decreased disease recurrence and mortality.

Keywords

Breast neoplasms Stage Surgery Follow-up Survival Mortality 

Notes

Acknowledgments

We wish to thank Ms Patricia Vigues for correcting the manuscript, Mr Manel Martori for helping up with tables and graphs, and finally to the staff of the Breast Cancer Screening Unit: Cristina Matarin, Pilar Cadenas, and Sandra Carmona, as well as to the staff of the Pathology Department (University Hospital of Mútua Terrassa): Francisca Perarnau, Maria Teresa Blanco, and Maribel Baldellon; all of them essential contributors keeping our breast cancer database updated.

Conflict of interest

None declared.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2014

Authors and Affiliations

  • A. García-Fernández
    • 1
    • 2
    Email author
  • C. Chabrera
    • 3
    • 13
  • M. García-Font
    • 4
  • M. Fraile
    • 5
  • I. Barco
    • 1
  • S. González
    • 6
  • L. Cirera
    • 6
  • J. M. Lain
    • 7
  • C. González
    • 8
  • E. Veloso
    • 9
  • L. Codina
    • 10
  • M. Piqueras
    • 10
  • A. Pessarrodona
    • 10
  • N. Gimenez
    • 11
    • 12
  1. 1.Breast Unit, Department of Gynecology, CTD, OTC, Programa detección Precoz Cáncer de MamaUniversity Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of BarcelonaTerrassaSpain
  2. 2.Department of GynecologyCatalan Institute of HealthBarcelonaSpain
  3. 3.Department of NursingSchool of Health Science TecnoCampus Mataró-MaresmeBarcelonaSpain
  4. 4.University International of CatalunyaBarcelonaSpain
  5. 5.Nuclear Medicine Department-CTD, University Hospital of Mútua TerrassaResearch Foundation Mútua Terrassa, University of BarcelonaBarcelonaSpain
  6. 6.Department of Hemato-oncology, University Hospital of Mútua TerrassaResearch Foundation Mútua Terrassa, University of BarcelonaBarcelonaSpain
  7. 7.Breast Unit, Department of GynecologyHospital of Terrassa, Health Consortium of TerrassaBarcelonaSpain
  8. 8.Department of PathologyUniversity Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of BarcelonaBarcelonaSpain
  9. 9.Department of SurgeryUniversity Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of BarcelonaBarcelonaSpain
  10. 10.Department of GynecologyUniversity Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of BarcelonaBarcelonaSpain
  11. 11.Research UnitResearch Foundation Mútua Terrassa, University of BarcelonaBarcelonaSpain
  12. 12.Laboratory of ToxicologyUniversitat Autònoma de BarcelonaBarcelonaSpain
  13. 13.Department of Hemato-oncologyCatalan Institute of OncologyBarcelonaSpain

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