Spanish Breast Cancer Research Group (GEICAM) hospital-based study on breast cancer outcomes: El Álamo project (1990-2001).

Abstract

e12016 Background: El Álamo project is a retrospective analysis of 26833 patients (pts) diagnosed of breast cancer (BC) between 1990 and 2001 across 43 of the main Spanish hospitals. Patterns of BC presentation, treatment and survival in the women population were analyzed. Methods: Three cohorts were analyzed: Álamo I (AI) with 4,532 pts diagnosed between 1990 and 1993; Álamo II (AII) with 10,791 pts diagnosed between 1994 and 1997; and Álamo III (AIII) with 11,277 pts diagnosed between 1998 and 2001. Data were collected by end of year 2000, 2003 and 2007 for AI, AII and AIII respectively. 468 items per pt were recorded, including demographic, therapeutic and outcome data. Results: Pts diagnosed with stage I were 17.6% in AI, 24.3% in AII and 32.7% in AIII; pts diagnosed with stage II were 55.5% in AI, 53.1% in AII and 44.9% in AIII; pts diagnosed with stage III were 18.7% in AI, 15% in AII and 15.7% in AIII; pts diagnosed with stage IV were 7.2% in AI, 5.9 in AII and 4.3% in AIII. Median age at diagnosis and menopausal status was similar in the three cohorts. First treatment option (FTO) for stage I, II, and III disease was surgery in 91% of pts in AI and AII and 89.5% in AIII; breast conserving surgery rate has increased through the cohorts from 19.5% in AI and 24% in AII to 48% in AIII. Neoadjuvant treatment was FTO for 8% of pts in AI and AII and 10.4% in AIII. Adjuvant systemic treatments (chemotherapy and/or hormones) were administered to 87.6% (AI), 92.8% (AII) and 95.7 % (AIII) of pts. Radiation therapy was administered to 38.8% (AI), 50.7% (AII) and 65.2% (AIII) of pts. BC recurrence rate has decreased from 36.6% (AI) to 22.5% (AII) and 15.9% (AIII). Six-year survival rate has increased from 72.50% (CI95%: 71.2-73.8) in AI, and 80,4% (CI95%: 79,6-81,2) in AII to 85.0% (CI95%: 84.3%-85.7%) in AIII. Conclusions: BC screening programs in Spain seem to accomplish the objectives as more patients are diagnosed with stage I disease and a higher amount of them are undergoing breast-conserving surgery. BC outcomes have improved through the consecutive cohorts. The main reason for that improvement is likely to be the BC screening program, nevertheless the impact of better surgical techniques, radiotherapy and new systemic therapies cannot be ruled out. No significant financial relationships to disclose.