Comprehensive trends in incidence, treatment, survival and mortality of first primary invasive breast cancer stratified by age, stage and receptor subtype in the Netherlands between 1989 and 2017

Abstract

Our study aimed to provide a comprehensive overview of trends in incidence, survival, mortality and treatment of first primary invasive breast cancer (BC), according to age, stage and receptor subtype in the Netherlands between 1989 and 2017. Data from all women diagnosed with first primary stage I to IV BC (N = 320 249) were obtained from the Netherlands Cancer Registry. BC mortality and general population data were retrieved from Statistics Netherlands. Age‐standardised incidence and mortality rates were calculated with annual percentage change (APC) and average annual percentage change (AAPC) statistics. The relative survival (RS) was used as estimator for disease‐specific survival. The BC incidence for all BC patients combined significantly increased until 2013 from 126 to 158 per 100 000 person‐years, after which a declining trend was observed. Surgery became less extensive, but (neo‐)adjuvant systemic treatments and their combinations were given more frequently. The RS improved for all age groups and for most stages and receptor subtypes, but remained stable for all subtypes since 2012 to 2013 and since 2000 to 2009 for Stage IV BC at 15 years of follow‐up. Overall, the 5‐ and 10‐year RS increased from 76.8% (95% confidence interval [CI]: 76.1, 77.4) and 55.9% (95% CI: 54.7, 57.1) in 1989 to 1999 to 91.0% (95% CI: 90.5, 91.5) and 82.9% (95% CI: 82.2, 83.5), respectively, in 2010 to 2016. BC mortality improved regardless of age and overall decreased from 57 to 35 per 100 000 person‐years between 1989 and 2017. In conclusion, the BC incidence in the Netherlands has steadily increased since 1989, but the latest trends show promising declines. Survival improved markedly for most patients and the mortality decreased regardless of age.

Real-world time trends in overall survival, treatments and patient characteristics in HR+/HER2− metastatic breast cancer: an observational study of the SONABRE Registry

“…Relevant to consider is the median age at early breast cancer diagnosis, which is about 61 years. 12 We observed that 51% of patients were diagnosed with distant metastases more than five and 28% more than ten years after primary HR+/HER2− diagnosis, which also explains an elderly age at ABC diagnosis. In comparison to other cohorts, the EU-5 cohort with 82,073 patients diagnosed with HR+/HER2− ABC in 2008–2010 reported 37% of patients aged above 70 years, identical to our results (i.e.…”

“…Obviously, the intensified early breast cancer treatment has led to a significant reduction in risk of recurrence and a better relative survival for patients diagnosed with early breast cancer. 12 , 13 , 14 But, for those who yet face a distant recurrence during follow-up, these shifts in the early breast cancer treatments may have changed the ABC patient baseline characteristics and may have worsened prognosis at time of ABC diagnosis. Conversely, the increased use of CDK4/6 inhibitors in daily practice is expected to lead to an improved overall survival for patients diagnosed with ABC since 2017.…”

Regulatory Approval, Reimbursement, and Clinical Use of Cyclin-Dependent Kinase 4/6 Inhibitors in Metastatic Breast Cancer in the Netherlands

“…We used incidence statistics of patients with breast cancer from the Netherlands Cancer Registry as a starting point. We then calculated the number of patients with HR-positive and ERBB2negative metastatic breast cancer per treatment line by applying proportions that were obtained from the literature [18][19][20][21][22][23] (ie, mainly a Dutch cohort study 21 ; Table 2) (eAppendix 3 and eFigure 2 in Supplement 1). In the Netherlands, the recommendation is to prescribe CDK4/6 inhibitors in the second line of treatment.…”

King Abdulaziz University Breast Cancer Mammogram Dataset (KAU-BCMD)

“…Breast screening is the only way to detect early breast cancer. Therefore, it is essential for women, especially those over 40 years, to undergo it periodically even if they have no symptoms [2,5,6]. Several methods are available for breast imaging, such as mammography, ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), and microwave imaging [7].…”