Abstract
585 Background: El Álamo project is a retrospective analysis of 15381 patients (pts) diagnosed of breast cancer (BC) between 1990 and 1997 across 43 of the main Spanish hospitals. Patterns of BC presentation, treatment and survival were analysed. Methods: Two cohorts were analysed: Álamo I (AI) consisted of 4532 pts diagnosed with BC between 1990 and 1993; data were collected by end of year (yr) 2000. Álamo II (AII) consisted of 10849 pts diagnosed between 1994 and 1997; data were collected by end of yr. 2003. 158 items per pt were recorded, including demographic, therapeutic and outcome data. Results: In AI project, 17.6% of pts presented with stage I disease, vs. 24.3% in AII. 55.5% of pts in AI had stage II disease vs. 53.1% in AII. 18.7% of pts in AI had stage III disease vs. 15% in AII. 7.2% of pts in AI presented with stage IV disease vs. 5.9 in AII. Median age at diagnosis was 57 yr (AI) vs. 58 yr (AII); 65.9% vs. 67.2% of pts were postmenopausal. Regarding first treatment (FT) for stage I, II & III disease, 91% of pts in both AI and AII underwent surgery. Breast conservative surgery rate has increased from 19.5% in AI to 24% in AII, (86.5% vs. 88% in tumours ≤ 3 cm). 8% both in AI and AII received neoadjuvant chemotherapy as FT. Adjuvant systemic treatments (chemo and/or hormones) were administered to 87.6% (AI) and 92.8% (AII) of operable patients. Radiation therapy was administered to 38.8% (AI) vs. 50.7% (AII). BC recurrence rate has diminished from 36.6% (AI) to 22.5% (AII). Nine-year survival rate has increased from 63.2% (CI95%; 61.5%–64.9%) in AI to 70.1% (CI95%; 68.5%–71.8%) in AII. Conclusions: BC outcomes in Spain seem to have improved from 1990–1993 to 1994–1997. The main reason for that improvement is likely to be the BC screening program implementation in Spain, although the impact of new therapies cannot be ruled out. No significant financial relationships to disclose.
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