Abstract
Background
The «Álamo» project is a retrospective analysis of 14,854 patients diagnosed of breast cancer between 1990 and 1997 in 50 Spanish hospitals.
Methods
Álamo I (AI) consisted of 4,532 patients diagnosed with breast cancer between 1990 and 1993. Data were collected in 2000. Álamo II (AII) consisted of 10,322 patients diagnosed between 1994 and 1997 Data were collected in 2003.
Results
At presentation, there were (AI vs. AII) 17.6% vs. 24.5% at stage I; 55.5% vs. 53.1% at stage II; 18.7% vs. 15% at stage III; 7.2% vs. 5.9 at stage IV. Median age was 57 (AI) vs. 58 years (AII) and 65.9% vs. 67.2% (AI vs. AII) were post-menopausal. First-line treatment for disease stages I, II and III was surgery in 91% of patients in both studies. Breast conserving surgery rate increased from 20.2% (AI) to 32.7% (AII). Adjuvant systemic treatments were administered to 87.6% (AI) and 92.8% (AII) of patients. Recurrence rate diminished from 36.6% (AI) to 22.5% (AII) and the 9-year survival rate increased from 63.2% (95% CI; 61.5–64.9) to 70.1% (95% CI: 68.5–71.8).
Conclusion
Breast cancer outcomes in Spain have improved from 1990–1995 to 1994–1997, likely because of breast cancer screening program implementation and new therapies.
Similar content being viewed by others
References
Althius MD, Dozier JD, Anderson WF, Devesa SS, Brinton LA. Global trends in breast cancer incidence and mortality 1973–1997. Int J Epidemiol. 2005;54(2):405–12.
López-Abente G, Pollán M, Aragonés N, Pérez-Gómez B. Informe sobre la salud de los españoles. http://195.146.50.130/htdocs/cancer/memoria-2003-cancer.pdf
Ferlay J, Bray F, Sankila R, Parkin DM. EUCAN: Cancer Incidence, Mortality and Prevalence in the European Union 1997, version 4.0 IARC CancerBase No. 4 Lyon IARCPress, 1999.
WHO-IARG, Worldwide cancer mortality statistics, International Agency for Research on Cancer 2002 www-depdb.iarc./fr/who/mortality.asp
INE http://www.ine.es.
www.geicam.org
Goldhirsch A, Glick JH, Gelber RD, Senn HJ, Meeting Highlights. International Consensus Panel on the Treatment of Primary Breast Cancer. J Natl Cancer Inst. 1998;90:1601–8.
Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER Stat Database: Incidence-SEER 9 Regs Public-Use, Nov 2004 Sub (1973–2002), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2005, based on the November 2004 submission.
Martín M, Llombart-Cussac A, Lluch A, et al. Proyecto El Álamo: Un estudio epidemiológico del grupo GEICAM sobre ei cáncer de mama es España (1990–1993). Medícina Clínica, 2004;122:12–7.
Rosen PP. Invasive mammary carcinoma. In: Harris JR, Lippman ME, Morrow M and Hellman, editors. Diseases of the Breast. Lippincott-Raven: Philadelphia; 1996. p. 393–444.
Malin JL, Schuster MA, Kahn KA, Brook RH. Quality of breast cancer care: What do we know? J Clin Oncol. 2002;20:4381–93.
Rhodes A, Jasani B, Balaton AJ, Barnes DM, Miller KD. Frequency of oestrogen and progesterone receptor positivey by immunohistochemical analysis in 7016 breast carcinomas: correlation with patient age, assay sensitivity, threshold value, and mammographic screening. J Clin Pathol. 2000;55:688–96.
Osteeu R, Steele G, Merck HR, Winchester DP, Regional differences in surgical management of breast cancer. CA Cancer J Clin. 1992;42:59–43.
Lazovich D, White E, Thomas DB, Moe RE, Taplin S. Change in the use of Breast-Conerving Surgery in Western Washington After the 1990 IH Consensus Development Conference. Arch Surg. 1997;132:418–23.
Fisher B, Bauer M, Margolese R, 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):665–75.
NIH Consensus Conference. Treatment of early breast cancer. JAMA. 1991;265:391–5.
Sant M, Aareleid T, Berrino F, et al. for the EUROCARE Working Group. EURO-CARE-3: survival of cancer patients diagnosed 1990-94-results and commentary. Ann Oncol. 2005;14Suppl 5:v61–118.
Andre F, Slimane K, Bachelot T, et al. Breast cancer with synchronous metastases: trends in survival during a 14-year period. J Clin Oncol. 2004;22(16):3302–8.
Giordano SH, Buzdar AU, Smith TL, Kau SW, Yang Y, Hortobagyi GN. Is breast cancer survival improving? Cancer. 2004;100 (1):44–52.
Colomer R, Viñas G, Beltrán M, et al. Validation of the 2001 St Gallen Risk Categories for Node-Negative Breast Cancer Using a Database From the Spanish Breast Cancer Research Group (GEICAM). J Clin Oncol. 2004. p. 961–2.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Martín, M., Mahillo, E., Llombart-Cussac, A. et al. The «El Álamo» project (1990–1997): two consecutive hospital-based studies of breast cancer outcomes in Spain. Clin Transl Oncol 8, 508–518 (2006). https://doi.org/10.1007/s12094-006-0051-7
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s12094-006-0051-7