Survival for breast cancer better now than 14 years ago

Breast cancer survival has been improving greatly over the last 14 years, an effect attributable to advancements in systemic therapy, a recent Korea study has found.

Researchers retrospectively analysed 17,776 breast cancer patients who had undergone treatment at the Asan Medical Centre between January 2000 and December 2013. The Centre’s database was accessed for relevant patient information, including clinical manifestations, pathology, treatment, and outcomes during follow-up.

Patients were divided into two cohorts according to their date of treatment: those who received care between 2000 and 2007 (P1; n=7,066) or 2018 and 2013 (P2; n=10,710). In general, patients were diagnosed with breast cancer before the age of 50 years, but P2 saw a significantly greater proportion of elderly patients than P1 (44.8 percent vs 36.2 percent; p<0.001).

The proportion of patients who were diagnosed at an early stage increased over time, as did the percentage of patients receiving neoadjuvant and HER-2 targeted therapy.

Kaplan-Meier survival curves showed that P2 patients had significantly better 5-year overall survival (OS) than P1 comparators (95.3 percent vs 92.6 percent, respectively). The same was true for breast cancer-specific survival (95.3 percent vs 92.6 percent), disease-free survival (DFS; 91.2 percent vs 87.9 percent), and distant metastasis-free survival (91.2 percent vs 87.9 percent; log-rank p<0.001 for all).

Multivariate Cox proportional hazards regression analysis confirmed that the time factor was a significant correlate of survival, with P2 yielding significantly better OS (hazard ratio [HR], 0.773, 95 percent confidence interval [CI], 0.684–0.873; p<0.001) and DFS (HR, 0.875, 95 percent CI, 0.788–0.972; p=0.013) than P1.

“We concluded that the recent improvement in Korean breast cancer patient outcomes might be due to advancements in systemic treatment,” the researchers said. “Moreover, as the time factor itself was a significant factor for survival improvement, better technological, economic, and social statuses might also be one of reasons for survival improvement.”