Abstract

PurposeThe aim of this study was to evaluate the chronological changes over 14 years in the survival of Korean patients with breast cancer. We also sought to investigate the factors that may have influenced the changes in survival rate.Materials and methodsWe retrospectively analyzed 17,776 breast cancer patients who were treated at Asan Medical Center between January 2000 and December 2013. Patient information was collected from the Asan database, including age at diagnosis, clinical manifestation, pathology report, types of treatment and modality, types of recurrence, and follow-up period. We classified the patients into two cohorts according to the year of their surgery (P1: 2000–2007 and P2: 2008–2013) and compared survival and recurrence between both cohorts.ResultsWe observed that patients treated more recently had better survival outcomes. The 5-year breast cancer-specific survival increased from 94.0% in P1 to 96.6% in P2 (p<0.001), and the 5-year disease-free survival increased from 87.9% in P1 to 91.2% in P2 (p<0.001). When analyzed by type of recurrence, distant metastasis-free survival increased to a significant degree. In subgroup analysis by the subtypes of breast cancer, the survival rates improved in all of the subtypes except triple negative breast cancer, and the improvement was more prominent in subtypes with overexpressed human epidermal growth factor receptor 2.ConclusionThis study showed improvement in breast cancer survival over the succeeding years, which is consistent with the advancement in systemic therapy.

Highlights

  • Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among females worldwide, accounting for 24.2% of total cancer incidence and 15% of total cancer mortality [1]

  • The 5-year breast cancer-specific survival increased from 94.0% in P1 to 96.6% in P2 (p

  • Korean breast cancer survival trends over a14-year period

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Summary

Introduction

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among females worldwide, accounting for 24.2% of total cancer incidence and 15% of total cancer mortality [1]. The incidence has risen rapidly and, according to the Korean National Cancer Center data, breast cancer is the most common cancer among Korean women, accounting for 23.8% of total female cancer incidence [6–8]. Many studies in western countries have reported improvement in the survival of breast cancer patients, and provided a few possible explanations for this trend [9]. These include nationwide screening programs that lead to early detection of breast cancer [10], an increased proportion of less aggressive types of breast cancer [9], and advancement in adjuvant therapy [11–14]. Unlike western countries, there are few investigations that have analyzed underlying causes for improvement in the survival of Korean patients

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