J Breast Cancer.  2015 Mar;18(1):8-15. 10.4048/jbc.2015.18.1.8.

Survival Improvement in Korean Breast Cancer Patients Due to Increases in Early-Stage Cancers and Hormone Receptor Positive/HER2 Negative Subtypes: A Nationwide Registry-Based Study

Affiliations
  • 1Department of Surgery, Sun Medical Center, Daejeon, Korea.
  • 2Department of Surgery, Seoul National University Hospital, Seoul, Korea. hanw@snu.ac.kr
  • 3Department of Surgery, Samsung Medical Center, Seoul, Korea.
  • 4Department of Surgery, Asan Medical Center, Seoul, Korea.
  • 5Department of Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea.
  • 6Department of Surgery, Dong-A University College of Medicine, Busan, Korea.

Abstract

PURPOSE
The aim of this study was to investigate whether the observed changes over time in the survival rates vary according to the intrinsic subtypes of breast cancer diagnosed.
METHODS
Data from 46,320 breast cancer patients in the Korean Breast Cancer Registry who underwent surgery between 1999 and 2006 were reviewed. Among them, results from 25,887 patients with available data about the status of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) were analyzed. Patients were classified into two cohorts according to the year in which they underwent surgery: 1999-2002 and 2003-2006.
RESULTS
The patients treated in the latter time period showed significantly better overall survival (OS) compared with those in the former period when adjusted for follow-up duration. The proportion of hormone receptor+/HER2-subtype and stage I breast cancer were significantly higher in the latter period (47.4% vs. 54.6%, p<0.001; 31.0% vs. 39.6%, p<0.001, respectively). Improvement in OS between the former and latter periods was seen in all subtypes of breast cancer, including triple-negative cancers (all p-values <0.001 in univariate and multivariate analyses).
CONCLUSION
Improvement in survival in Korean breast cancer patients over the study years is being observed in all subtypes of breast cancer, implying that increases in both early-stage detection and the proportion of less aggressive cancers contribute to this improvement.

Keyword

Breast neoplasms; Clinical characteristics; Korea; Registries

MeSH Terms

Breast Neoplasms*
Cohort Studies
Estrogens
Follow-Up Studies
Humans
Korea
Receptor, Epidermal Growth Factor
Receptors, Progesterone
Registries
Survival Rate
Estrogens
Receptor, Epidermal Growth Factor
Receptors, Progesterone

Figure

  • Figure 1 Study enrollment scheme. HER2=human epidermal growth factor receptor 2; ER=estrogen receptor; PR=progesterone receptor; IHC=immunohistochemistry; AJCC=American Joint Committee on Cancer.

  • Figure 2 Chronological changes in Korean breast cancer during 1999 to 2006. The incidence of Korean breast cancer during 1999 to 2006 demonstrated by the subtype (A) and the stage (B). Proportional change of Korean breast cancer during 1999 to 2006 demonstrated by the subtype (C) and the stage (D). HR=hormone receptor; HER2=human epidermal growth factor receptor 2.

  • Figure 3 Relative survival plot of Korean breast cancer according to the subtype. (A) HR+/HER2-. (B) HR+/HER2+. (C) HR-/HER2+. (D) HR-/HER2-. HR=hormone receptor; HER2=human epidermal growth factor receptor 2.

  • Figure 4 Kaplan-Meier survival plot of the HR+ (ER+ and/or PR+) subtype tumor according to the use of aromatase inhibitors (AIs). There is nonsignificant survival difference between the selective estrogen receptor modulator (SERM)-only use group and AIs use group (p=0.206). HR=hormone receptor; ER=estrogen receptor; PR=progesterone receptor; CI=confidence interval.


Cited by  1 articles

Chronological Improvement in Survival of Patients with Breast Cancer: A Large-Scale, Single-Center Study
Sae Byul Lee, Guiyun Sohn, Jisun Kim, Il Yong Chung, Hee Jeong Kim, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Sung-Bae Kim, Sei-Hyun Ahn
J Breast Cancer. 2018;21(1):70-79.    doi: 10.4048/jbc.2018.21.1.70.


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