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Published in: European Journal of Epidemiology 2/2008

01-02-2008 | CANCER

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

Authors: Thomas P. Ahern, Heidi Larsson, Jens Peter Garne, Deirdre P. Cronin-Fenton, Henrik Toft Sørensen, Timothy L. Lash

Published in: European Journal of Epidemiology | Issue 2/2008

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Abstract

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.
Literature
1.
go back to reference Veronesi U, Zurrida S. Breast cancer surgery: a century after Halsted. J Cancer Res Clin Oncol 1996;122(2):74–7.PubMedCrossRef Veronesi U, Zurrida S. Breast cancer surgery: a century after Halsted. J Cancer Res Clin Oncol 1996;122(2):74–7.PubMedCrossRef
2.
go back to reference 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 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
3.
go back to reference Mustakallio S. Conservative treatment of breast carcinoma–review of 25 years follow up. Clin Radiol 1972;23(1):110–6.PubMedCrossRef Mustakallio S. Conservative treatment of breast carcinoma–review of 25 years follow up. Clin Radiol 1972;23(1):110–6.PubMedCrossRef
4.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
5.
go back to reference 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 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
6.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
7.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
8.
go back to reference 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. 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.
go back to reference 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. 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.
10.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
11.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
12.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
13.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
14.
go back to reference Greenland S. Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology 1995;6(4):356–65.PubMedCrossRef Greenland S. Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology 1995;6(4):356–65.PubMedCrossRef
15.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
16.
go back to reference 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 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
17.
go back to reference 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. 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.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
Metadata
Title
Trends in breast-conserving surgery in Denmark, 1982–2002
Authors
Thomas P. Ahern
Heidi Larsson
Jens Peter Garne
Deirdre P. Cronin-Fenton
Henrik Toft Sørensen
Timothy L. Lash
Publication date
01-02-2008
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 2/2008
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-007-9207-1

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