Abstract
6044 Background: El Álamo project is a retrospective analysis of 15381 patients (pts) diagnosed of breast cancer (BC) across 43 of the main Spanish hospitals. Methods: Two cohorts were analysed: Álamo I (AI) consisted of 4532 pts diagnosed with BC between 1990 and 1993; Álamo II (AII) consisted of 10849 pts diagnosed between 1994 and 1999. AI and AII data were collected by end of year (yr) 2000 and 2003, respectively. 158 items per pt were recorded, including demographic, therapeutic and outcome data. Pts with operable node negative (NN) disease were selected. Results: In AI project, 48% (n=1806) of all pts presented with NN disease, vs. 54.4% in AII (n=4764). Median age at diagnosis was 58 yr (AI) vs. 59 yr (AII); 67.4% vs. 69.6% of pts were postmenopausal. T1 percentage increased from 47.6% (AI) to 57.4% (AII). Regarding treatment, 94% of pts in AII received adjuvant therapy (AT) vs. 86.3% in AI. AT in AI group were: chemotherapy (CT) (37.4%), hormone therapy (HT) (50.4%) and radiotherapy (RT) (32.4%). AT in AII group were: CT (43.1%), HT (70.2%) and RT (44.2%). 73.7% (AI) vs. 73.1% (AII) of pts were classified as high-risk according to 1998 St. Gallen criteria (tumour size > 2 cm and/or grade II/III and/or negative hormone receptors and/or age < 35 yr). BC recurrence rate has diminished from 22.3% (AI) to 13.4% (AII). Bone, lung and mastectomy scar are the most frequent recurrence sites. Nine-year survival rates for AI and AII were 75.6% (CI95%; 72.2%–79%) and 83.6% (CI95%; 81.4%–85.7%) respectively. Conclusions: The relative population of operable, NN BC pts has increased by 6.4% in Spain between 1990 and 1997. In addition to that, the relative percentage of T1 tumors has also increased. This is likely to be the reason of BC outcome improvement in this group, although a contribution of more effective therapies cannot be ruled out. No significant financial relationships to disclose.
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