J Breast Cancer.  2018 Mar;21(1):70-79. 10.4048/jbc.2018.21.1.70.

Chronological Improvement in Survival of Patients with Breast Cancer: A Large-Scale, Single-Center Study

• Lee SB
• Sohn G
• Kim J
• Chung IY
• Kim HJ
• Ko BS
• Lee JW
• Son BH
• Kim SB
• Ahn SH

• KMID: 2441870
• DOI: http://doi.org/10.4048/jbc.2018.21.1.70

Abstract

PURPOSE
This study aimed to chronologically evaluate survival of patients with breast cancer in Korea and investigate the observed changes during the last 20 years. We also sought to determine factors that may influence outcomes and changes in the duration of survival over time.
METHODS
We retrospectively analyzed a total of 10,988 patients with breast cancer who were treated at our institution between January 1993 and December 2008. We divided the study period into three periods (P1, 1993-1997; P2, 1998-2002; and P3, 2003-2008). We retrospectively reviewed the collected data from the Asan database, including age at diagnosis, clinical manifestations, pathology report, surgical methods, types of adjuvant treatment modalities, type of recurrence, and follow-up period.
RESULTS
At a median follow-up of 8.2 years, we observed that survival outcomes have improved recently. The 5-year breast cancer-specific survival (BCSS) rate also increased from 82.8% in P1 to 92.6% in P3 (p < 0.001). The survival rate in patients with tumors at each stage increased in similar patterns in all patients, and, remarkably, there was a significant survival improvement in patients with stage III breast cancer (P1 vs. P3: 5-year BCSS, 57.4% vs. 80.0%, p < 0.001). The time period was a significant prognostic factor in multivariate analysis (P1 vs. P2: hazard ratio [HR], 0.83, p=0.035; P1 vs. P3: HR, 0.75, p=0.015).
CONCLUSION
The study results suggest an improvement in breast cancer survival in Korea, which is consistent with the development of treatments and early detection.

Keyword

Breast neoplasms; Prognosis; Recurrence; Survival

MeSH Terms

Breast Neoplasms*
Breast*
Chungcheongnam-do
Diagnosis
Follow-Up Studies
Humans
Korea
Multivariate Analysis
Pathology
Prognosis
Recurrence
Retrospective Studies
Survival Rate

Figure

• 

  Figure 1 Chronological changes of survival in patients with primary breast cancer. Disease-free survival (DFS) (A), overall survival (OS) (B), and breast cancer-specific survival (BCSS) (C) of breast cancer according to periods at diagnosis in overall series.

• 

  Figure 2 Chronological changes of survival in patients with primary breast cancer according to stage. Subgroup analyses of breast cancer-specific survival (BCSS) by stage, stage 0 (A), stage I (B), stage II (C), stage III (D), and stage IV (E). Subgroup analyses of disease-free survival (DFS) by stage, stage 0 (F), stage I (G), stage II (H), and stage III (I).

• 

  Figure 3 Disease-free survival (DFS) according to recurrence type in patients with breast cancer. DFS according to periods at diagnosis in overall series. Local DFS (A), regional DFS (B), and systemic DFS (C).

• 

  Figure 4 Disease-free survival (DFS) according to recurrence type in patients with breast cancer by stage. DFS according to periods at diagnosis in stage I (A-C), stage II (D-F), and stage III (G-I).

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