Article Figures & Tables
Figures
- Fig. 1:
Overall survival among 2927 patients in whom breast cancer was diagnosed in 2002 in British Columbia, by stage of cancer at diagnosis. The columns of numbers at the bottom of the graph show the number of patients at risk every 2 years, by stage of cancer (stage 0 to stage 4).
- Fig. 2:
Breast cancer–specific survival among 2927 patients in whom breast cancer was diagnosed in 2002 in British Columbia, by stage of cancer at diagnosis. The columns of numbers at the bottom of the graph show the number of patients at risk every 2 years, by stage of cancer (stage 0 to stage 4).
Tables
Stage of cancer; no. (%) of patients* All stages
n = 2927Stage 0
n = 424Stage I
n = 1118Stage II
n = 938Stage III
n = 233Stage IV
n = 123Unknown
n = 91% of all patients 100 14 38 32 8 4 3 Sex, female 2909 (99) 422 (>99) 1116 (>99) 933 (99) 229 (98) 122 (99) 87 (96) Age at diagnosis Median (range) 61 (27–102) 58 (28–94) 62 (29–98) 58 (27–101) 59 (30–95) 64 (35–96) 74 (39–102) < 40 127 (4) 6 (1) 38 (3) 62 (7) 15 (6) 5 (4) 1 (1) 40–49 538 (18) 100 (24) 176 (16) 201 (21) 46 (20) 9 (7) 6 (7) 50–59 719 (25) 124 (29) 261 (23) 226 (24) 62 (27) 33 (27) 13 (14) 60–69 660 (23) 95 (22) 290 (26) 185 (20) 40 (17) 29 (24) 21 (23) 70–79 583 (20) 74 (17) 267 (24) 164 (17) 35 (15) 23 (19) 20 (22) ≥ 80 300 (10) 25 (6) 86 (8) 100 (11) 35 (15) 24 (20) 30 (33) Margin status Positive 123 (4) 14 (3) 20 (2) 39 (4) 26 (11) 15 (12) 9 (10) Negative 2356 (80) 371 (88) 990 (89) 795 (85) 168 (72) 32 (26) 0 (0) Close 165 (6) 29 (7) 56 (5) 61 (7) 16 (7) 3 (2) 0 (0) Unknown 283 (10) 10 (2) 52 (5) 43 (5) 23 (10) 73 (59) 82 (90) Size of tumour, cm Median (range) 1.7 (0.1–9.9) 1.5 (0.1–9.9) 1.2 (0.1–2.0) 2.5 (0.1–9.9) 5.4 (0.1–9.9) 4.3 (0.4–9.9) 1.3 (1.1–1.5) < 1.0 529 (18) 122 (29) 370 (33) 27 (3) 8 (3) 2 (2) 0 (0) 1.0–2.0 1110 (38) 139 (33) 708 (63) 227 (24) 20 (9) 14 (11) 2 (2) 2.1–5.0 822 (28) 90 (21) 0 (0) 628 (67) 70 (30) 34 (28) 0 (0) > 5.0 204 (7) 34 (8) 0 (0) 19 (2) 115 (49) 36 (29) 0 (0) Unknown 262 (9) 39 (9) 40 (4) 37 (4) 20 (9) 37 (30) 89 (98) ER status Positive 1920 (66) 30 (7) 943 (84) 707 (75) 165 (71) 63 (51) 12 (13) Negative 457 (16) 13 (3) 139 (12) 219 (23) 57 (24) 26 (21) 3 (3) Unknown 550 (19) 381 (90) 36 (3) 12 (1) 11 (5) 34 (28) 76 (84) Grade 1 784 (27) 85 (20) 487 (44) 177 (19) 22 (9) 9 (7) 4 (4) 2 1050 (36) 152 (36) 413 (37) 361 (38) 82 (35) 35 (28) 7 (8) 3 875 (30) 147 (35) 195 (17) 383 (41) 108 (46) 38 (31) 4 (4) Unknown 218 (7) 40 (9) 23 (2) 17 (2) 21 (9) 41 (33) 76 (84) LVI Positive 519 (18) 0 (0) 77 (7) 297 (32) 114 (49) 28 (23) 3 (3) Negative 1747 (60) 18 (4) 994 (89) 600 (64) 85 (36) 40 (33) 10 (11) Unknown 661 (23) 406 (96) 47 (4) 41 (4) 34 (15) 55 (45) 78 (86) No. of positive nodes 0 1439 (49) 71 (17) 1005 (90) 339 (36) 17 (7) 7 (6) 0 (0) 1–3 497 (17) 0 (0) 0 (0) 422 (45) 65 (28) 10 (8) 0 (0) ≥ 4 252 (9) 0 (0) 0 (0) 124 (13) 107 (46) 20 (16) 1 (1) Positive, no. unknown 3 (<1) 0 (0) 0 (0) 0 (0) 3 (1) 0 (0) 0 (0) Nodal status unknown 736 (25) 353 (83) 113 (10) 53 (6) 41 (18) 86 (70) 90 (99) SMPBC attender Yes 1574 (54) 302 (71) 704 (63) 431 (46) 81 (35) 33 (27) 23 (25) No 1353 (46) 122 (29) 414 (37) 507 (54) 152 (65) 90 (73) 68 (75) Screen detected† Yes 971 (62) 238 (79) 499 (71) 189 (44) 25 (31) 11 (33) 9 (39) No 603 (38) 64 (21) 205 (29) 242 (56) 56 (69) 22 (67) 14 (61) Note: ER = estrogen receptor, LVI = lymphovascular invasion, SMPBC = Screening Mammography Program of British Columbia. *Unless otherwise indicated. †Defined as diagnosis of breast cancer within 1 year after abnormal results on screening. For patients with synchronous bilateral disease, the first diagnosis was used to define the screen-detection variable, which was then assigned to both diagnoses.
Stage of cancer; no. (%) of patients All stages
n = 2927Stage 0
n = 424Stage I
n = 1118Stage II
n = 938Stage III
n = 233Stage IV
n = 123Unknown
n = 91Initial surgery None 121 (4) 1 (<1) 7 (1) 13 (1) 22 (9) 65 (53) 13 (14) Breast-conserving 1510 (52) 281 (66) 726 (65) 445 (47) 34 (15) 22 (18) 2 (2) Mastectomy 1086 (37) 104 (25) 344 (31) 458 (49) 154 (66) 22 (18) 4 (4) Unknown 210 (7) 38 (9) 41 (4) 22 (2) 23 (10) 14 (11) 72 (79) Radiotherapy Within 1 yr of diagnosis 1649 (56) 159 (38) 655 (59) 599 (64) 179 (77) 57 (46) 0 (0) Within 5 yr of diagnosis 1715 (59) 167 (39) 679 (61) 619 (66) 184 (79) 65 (53) 1 (1) Within 1 yr of breast-conserving surgery* 1214 (80) 155 (55) 639 (88) 394 (89) 26 (76) NA NA Chemotherapy Within 1 yr of diagnosis 928 (32) 0 (0) 159 (14) 543 (58) 166 (71) 53 (43) 7 (8) Within 5 yr of diagnosis 978 (33) 0 (0) 177 (16) 558 (59) 168 (72) 61 (50) 14 (15) Hormone therapy Within 1 yr of diagnosis (all) 1664 (57) 95 (22) 709 (63) 610 (65) 156 (67) 63 (51) 31 (34) Within 5 yr of diagnosis (all patients) 1773 (61) 109 (26) 734 (66) 657 (70) 169 (73) 67 (54) 37 (41) Within 1 yr of diagnosis (ER+) 1493 (78) 7 (23) 695 (74) 590 (83) 143 (87) 52 (83) 6 (50) Note: ER+ = estrogen receptor-positive, NA = not applicable (use of radiotherapy after breast-conserving surgery is not relevant for patients with stage IV or unknown stage cancer). *Percentages calculated on the basis of number who had breast-conserving surgery.
Variable Breast cancer–specific survival Overall survival Hazard ratio (95% CI) Hazard ratio (95% CI) Age, per yr 1.02 (1.00–1.03) 1.06 (1.05–1.07) Grade 2 v. 1 2.0 (1.3–2.9) 1.3 (1.0–1.6) 3 v. 1 3.5 (2.3–5.2) 1.9 (1.5–2.4) LVI, positive v. negative 1.6 (1.2–2.0) 1.5 (1.2–1.8) Stage II v. I 3.0 (2.2–4.3) 1.5 (1.2–1.8) III v. I 9.8 (6.5–14.7) 4.0 (3.1–5.2) IV v. I 47.0 (30.6–73.1) 15.5 (11.0–22.0) Radiotherapy* 0.76 (0.60–0.96) 0.68 (0.60–0.80) Chemotherapy* 0.58 (0.43–0.78) NA NA Hormone therapy* 0.74 (0.59–0.95) 0.70 (0.59–0.83) Note: CI = confidence interval, LVI = lymphatic vascular space invasion, NA = not applicable. *Within 1 year of diagnosis, expressed as the hazard ratio of having had treatment v. not having had treatment.
- Table 4: Stage distribution of cases of breast cancer in British Columbia (this study) and US Surveillance Epidemiology and End Results (SEER) (22)
% of cases Stage British Columbia (this study) SEER In situ 14 15 I 38 42 II 32 32 II 8 7 IV 4 4 Unknown 3 - - Table 5: Comparison of 5-year utilization rates for various therapies in British Columbia with optimal utilization*
Stage; % of cases Type of therapy All I II III IV Radiotherapy BCCA data (within 5 yr) 59 61 66 79 52 Ideal (Foroudi et al. (24)) 66 69 82 95 64 Ideal (Delaney et al. (25)) 83 84 84 91 47 Chemotherapy† BCCA data (within 5 yr) 34
(adjusted: 39)16 59 72 49 Ideal (Ng et al. (26)) 59
(adjusted: 69)56 56 90 29 Hormone therapy† BCCA data (within 5 yr) 61
(adjusted: 68)66 70 73 54 Ideal (Fong et al. (27)) 57
(adjusted: 67)NR NR NR NR Note: BCCA = BC Cancer Agency, NR = not reported. *Optimal (ideal) rates of utilization are based on evidence-based estimates of needs. Details of how these estimates were obtained are outlined in the cited references. †For chemotherapy and hormone therapy, the “all stages” rates were adjusted to account for exclusion of in situ cases; the parenthetical values are these adjusted rates, for invasive cancers only. In particular, Fong and associates (27) assumed that hormone therapy is not indicated for in situ breast cancer.
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