Trend of Breast Cancer Treatment in 30 Years_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHONG Ying , SUN Qiang , XU Yali , ZHOU Yidong , MAO Feng , GUAN Jinghong , LIN Yan

Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &;
Peking Union Medical College, Beijing 100730, China;

Corresponding author：

Keywords：

Breast cancer; Treatment; Tendency; Chemotherapy; Radiotherapy; Endocrine therapy

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Objective To investigate the trend of breast cancer treatment and prognosis in 30 years. Methods Total 1 092 patients with breast cancer treated in the Peking Union Medical College Hospital between 1975 and 2006 were reviewed in six time phases for therapy, metastasis, and survival rate. Six time phases were 1975-1980 years, 1985-1986 years, 1990-1991 years, 1995-1996 years, 2000-2001 years and 2005-2006 years. Results Radical operation was the major treatment (68.9%， 91/132) of breast cancer in 1975-1980 and then became less popular until it was totally abandoned after 2001. The number of modified radical operation begun to rise from 1980 and reached its peak in 1995-1996 (94.9%， 146/154). The number of lumpectomy had been increasing since 2000, and that of chemotherapy had been rising since 1985-1986. But there was no apparent change of the percentage of radiotherapy treatment. In 1975-1980, only 0.8% （1/126） patients received endocrine therapy, but in 1990-1991, the ratio was 66.0% （33/50）. The metastasis and recurrence ratio was declining gradually in the 6 time phases (P＜0.05). The 5-year and 10-year disease free survival rates in the groups of 1990-1991, 1995-1996, 2000-2001, and 2005-2006 were apparently higher than those in two earlier groups of 1975-1980 and 1985-1986 (P＜0.05). Conclusion The conclusions of laboratory experiments and clinical trials on breast cancer are critical for improving prognosis.

Citation： ZHONG Ying,SUN Qiang,XU Yali,ZHOU Yidong,MAO Feng,GUAN Jinghong,LIN Yan. Trend of Breast Cancer Treatment in 30 Years. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(11): 911-917. doi: Copy

1.	Fremgen AM, Bland KI, McGinnis LS Jr, et al. Clinical highlights from the National Cancer Data Base, 1999 [Ｊ]. CA Cancer J Clin, 1999; 49(3): 145-158.
2.	Halsted WS. A Clinical and Histological Study of certain Adenocarcinomata of the Breast: and a Brief Consideration of the Supraclavicular Operation and of the Results of Operations for Cancer of the Breast from 1889 to 1898 at the Johns Hopkins Hospital [Ｊ]. Ann Surg, 1898; 28(5): 557-576.
3.	Halsted WS. The Results of Radical Operations for the Cure of Carcinoma of the Breast [Ｊ]. Ann Surg, 1907; 46(1): 1-19.
4.	Fisher B, Fisher ER. Biologic aspects of cancer-cell spread [A]. In: Proceedings of the Fifth National Cancer Conference[C]. Philadelphia, Pennsylvania: Lippincott, 1965: 105-122.
5.	Fisher B, Fisher ER. The biology of metastasis[A]. In: Davis JH eds. Current Concepts in Surgery [M]. New York: McGraw Hill, 1965: 321-351.
6.	Fisher ER, Fisher B. Host-tumor relationship in the development and growth of hepatic metastases [A]. In: Wissler RW, Dao TL, Wood Jr S eds. Endogenous Factors Influencing Host-Tumor Balance [M]. Chicago: University of Chicago Press, 1967: 149-166.
7.	Fisher B, Fisher ER. Metastases of cancer cells [A]. In: Busch H eds. Methods in Cancer Research [M]. New York: Academic Press, 1967: 243-286.
8.	Fisher B. Laboratory and clinical research in breast cancer-a personal adventure: the David A. Karnofsky memorial lecture [Ｊ]. Cancer Res, 1980; 40(11): 3863-3874.
9.	Fisher B. The interdependence of laboratory and clinical research in the study of metastases [A]. In: Nicolson GL, Miles L eds. Cancer Invasion and Metastasis: Biologic and Therapeutic Aspects [M]. New York: Raven Press, 1984: 27-46.
10.	Fisher B, Redmond C, Fisher ER. Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation [Ｊ]. N Engl J Med, 1985; 312(11): 674-681.
11.	National Surgical Adjuvant Breast and Bowel Project (NSABP). Progress Report [R]. July 1998: 17-23.
12.	Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer [Ｊ]. N Engl J Med, 1995; 333(22): 1456-1461.
13.	National Surgical Adjuvant Breast and Bowel Project (NSABP). Progress Report [R]. July 1998: 31-39.
14.	孙强, 黄汉源, 周易冬, 等.　 X线立体定位乳腺活检术的临床应用 [Ｊ]. 中国实用外科杂志, 2000; 20(5): 281-282.
15.	Fisher ER, Turnbull RB Jr. The cytologic demonstration and significance of tumor cells in the mesenteric venous blood in patients with colorectal carcinoma [Ｊ]. Surg Gynecol Obstet, 1955; 100(1): 102-108.
16.	Shapiro DM, Fugmann RA. A role for chemotherapy as an adjunct to surgery [Ｊ]. Cancer Res, 1957; 17(11): 1098-1101.
17.	Fisher B, Carbone P, Economou SG, et al. 1-Phenylalanine mustard (L-PAM) in the management of primary breast cancer. A report of early findings [Ｊ]. N Engl J Med, 1975; 292(3): 117-122.
18.	Bonadonna G, Brusamolino E, Valagussa P, et al. Combination chemotherapy as an adjuvant treatment in operable breast cancer [Ｊ]. N Engl J Med, 1976; 294(8): 405-410.
19.	Polychemotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group [Ｊ]. Lancet, 1998; 352(9132): 930-942.
20.	Martin M, Pienkowski T, Mackey J, et al. Adjuvant docetaxel for node-positive breast cancer [Ｊ]. N Engl J Med, 2005; 352(22): 2302-2313.
21.	Overgaard M, Hansen PS, Overgaard J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial [Ｊ]. N Engl J Med, 1997; 337(14): 949-955.
22.	Whelan TJ, Julian J, Wright J, et al. Does locoregional radiation therapy improve survival in breast cancer? A meta-analysis A meta-analysis [Ｊ]. J Clin Oncol, 2000; 18(6): 1220-1229.
23.	Recht A, Edge SB, Solin LJ, et al. Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology [Ｊ]. J Clin Oncol, 2001; 19(5): 1539-1569.
24.	Heuson JC. Current overview of EORTC clinical trials with tamoxifen [Ｊ]. Cancer Treat Rep, 1976; 60(10): 1463-1466.
25.	Mouridsen H, Palshof T, Patterson J, et al. Tamoxifen in advanced breast cancer [Ｊ]. Cancer Treat Rev, 1978; 5(3): 131-141.
26.	Legha SS, Buzdar AU, Hortobagyi GN, et al. Tamoxifen. Use in treatment of metastatic breast cancer refractory to combination chemotherapy [Ｊ]. JAMA, 1979; 242(1): 49-52.
27.	Margreiter R, Wiegele J. Tamoxifen (Nolvadex) for premenopausal patients with advanced breast cancer [Ｊ]. Breast Cancer Res Treat, 1984; 4(1): 45-48.
28.	Controlled trial of tamoxifen as adjuvant agent in management of early breast cancer. Interim analysis at four years by Nolvadex Adjuvant Trial Organisation [Ｊ]. Lancet, 1983; 1(8319): 257-261.
29.	Controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer. Analysis at six years by Nolvadex Adjuvant Trial Organisation [Ｊ]. Lancet, 1985; 1(8433): 836-840.
30.	Adjuvant tamoxifen in the management of operable breast cancer: the Scottish Trial. Report from the Breast Cancer Trials Committee, Scottish Cancer Trials Office (MRC), Edinburgh [Ｊ]. Lancet, 1987; 2(8552): 171-175.
31.	Fisher B, Costantino J, Redmond C, et al. A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors [Ｊ]. N Engl J Med, 1989; 320(8): 479-484.
32.	Fisher B, Dignam J, Bryant J, et al. Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors [Ｊ]. J Natl Cancer Inst, 1996; 88(21): 1529-1542.
33.	Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group [Ｊ]. Lancet, 1998; 351(9114): 1451-1467.
34.	Fisher B, Dignam J, Bryant J, et al. Five versus more than five years of tamoxifen for lymph node-negative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B-14 randomized trial [Ｊ]. J Natl Cancer Inst, 2001; 93(9): 684-690.
35.	Aydiner A, Tas F. Meta-analysis of trials comparing anastrozole and tamoxifen for adjuvant treatment of postmenopausal women with early breast cancer [Ｊ]. Trials, 2008; 9: 47.
36.	Crivellari D, Sun Z, Coates AS, et al. Letrozole compared with tamoxifen for elderly patients with endocrine-responsive early breast cancer: the BIG 1-98 trial [Ｊ]. J Clin Oncol, 2008; 26(12): 1972-1979.

1. Fremgen AM, Bland KI, McGinnis LS Jr, et al. Clinical highlights from the National Cancer Data Base, 1999 [Ｊ]. CA Cancer J Clin, 1999; 49(3): 145-158.
2. Halsted WS. A Clinical and Histological Study of certain Adenocarcinomata of the Breast: and a Brief Consideration of the Supraclavicular Operation and of the Results of Operations for Cancer of the Breast from 1889 to 1898 at the Johns Hopkins Hospital [Ｊ]. Ann Surg, 1898; 28(5): 557-576.
3. Halsted WS. The Results of Radical Operations for the Cure of Carcinoma of the Breast [Ｊ]. Ann Surg, 1907; 46(1): 1-19.
4. Fisher B, Fisher ER. Biologic aspects of cancer-cell spread [A]. In: Proceedings of the Fifth National Cancer Conference[C]. Philadelphia, Pennsylvania: Lippincott, 1965: 105-122.
5. Fisher B, Fisher ER. The biology of metastasis[A]. In: Davis JH eds. Current Concepts in Surgery [M]. New York: McGraw Hill, 1965: 321-351.
6. Fisher ER, Fisher B. Host-tumor relationship in the development and growth of hepatic metastases [A]. In: Wissler RW, Dao TL, Wood Jr S eds. Endogenous Factors Influencing Host-Tumor Balance [M]. Chicago: University of Chicago Press, 1967: 149-166.
7. Fisher B, Fisher ER. Metastases of cancer cells [A]. In: Busch H eds. Methods in Cancer Research [M]. New York: Academic Press, 1967: 243-286.
8. Fisher B. Laboratory and clinical research in breast cancer-a personal adventure: the David A. Karnofsky memorial lecture [Ｊ]. Cancer Res, 1980; 40(11): 3863-3874.
9. Fisher B. The interdependence of laboratory and clinical research in the study of metastases [A]. In: Nicolson GL, Miles L eds. Cancer Invasion and Metastasis: Biologic and Therapeutic Aspects [M]. New York: Raven Press, 1984: 27-46.
10. Fisher B, Redmond C, Fisher ER. Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation [Ｊ]. N Engl J Med, 1985; 312(11): 674-681.
11. National Surgical Adjuvant Breast and Bowel Project (NSABP). Progress Report [R]. July 1998: 17-23.
12. Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer [Ｊ]. N Engl J Med, 1995; 333(22): 1456-1461.
13. National Surgical Adjuvant Breast and Bowel Project (NSABP). Progress Report [R]. July 1998: 31-39.
14. 孙强, 黄汉源, 周易冬, 等.　 X线立体定位乳腺活检术的临床应用 [Ｊ]. 中国实用外科杂志, 2000; 20(5): 281-282.
15. Fisher ER, Turnbull RB Jr. The cytologic demonstration and significance of tumor cells in the mesenteric venous blood in patients with colorectal carcinoma [Ｊ]. Surg Gynecol Obstet, 1955; 100(1): 102-108.
16. Shapiro DM, Fugmann RA. A role for chemotherapy as an adjunct to surgery [Ｊ]. Cancer Res, 1957; 17(11): 1098-1101.
17. Fisher B, Carbone P, Economou SG, et al. 1-Phenylalanine mustard (L-PAM) in the management of primary breast cancer. A report of early findings [Ｊ]. N Engl J Med, 1975; 292(3): 117-122.
18. Bonadonna G, Brusamolino E, Valagussa P, et al. Combination chemotherapy as an adjuvant treatment in operable breast cancer [Ｊ]. N Engl J Med, 1976; 294(8): 405-410.
19. Polychemotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group [Ｊ]. Lancet, 1998; 352(9132): 930-942.
20. Martin M, Pienkowski T, Mackey J, et al. Adjuvant docetaxel for node-positive breast cancer [Ｊ]. N Engl J Med, 2005; 352(22): 2302-2313.
21. Overgaard M, Hansen PS, Overgaard J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial [Ｊ]. N Engl J Med, 1997; 337(14): 949-955.
22. Whelan TJ, Julian J, Wright J, et al. Does locoregional radiation therapy improve survival in breast cancer? A meta-analysis A meta-analysis [Ｊ]. J Clin Oncol, 2000; 18(6): 1220-1229.
23. Recht A, Edge SB, Solin LJ, et al. Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology [Ｊ]. J Clin Oncol, 2001; 19(5): 1539-1569.
24. Heuson JC. Current overview of EORTC clinical trials with tamoxifen [Ｊ]. Cancer Treat Rep, 1976; 60(10): 1463-1466.
25. Mouridsen H, Palshof T, Patterson J, et al. Tamoxifen in advanced breast cancer [Ｊ]. Cancer Treat Rev, 1978; 5(3): 131-141.
26. Legha SS, Buzdar AU, Hortobagyi GN, et al. Tamoxifen. Use in treatment of metastatic breast cancer refractory to combination chemotherapy [Ｊ]. JAMA, 1979; 242(1): 49-52.
27. Margreiter R, Wiegele J. Tamoxifen (Nolvadex) for premenopausal patients with advanced breast cancer [Ｊ]. Breast Cancer Res Treat, 1984; 4(1): 45-48.
28. Controlled trial of tamoxifen as adjuvant agent in management of early breast cancer. Interim analysis at four years by Nolvadex Adjuvant Trial Organisation [Ｊ]. Lancet, 1983; 1(8319): 257-261.
29. Controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer. Analysis at six years by Nolvadex Adjuvant Trial Organisation [Ｊ]. Lancet, 1985; 1(8433): 836-840.
30. Adjuvant tamoxifen in the management of operable breast cancer: the Scottish Trial. Report from the Breast Cancer Trials Committee, Scottish Cancer Trials Office (MRC), Edinburgh [Ｊ]. Lancet, 1987; 2(8552): 171-175.
31. Fisher B, Costantino J, Redmond C, et al. A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors [Ｊ]. N Engl J Med, 1989; 320(8): 479-484.
32. Fisher B, Dignam J, Bryant J, et al. Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors [Ｊ]. J Natl Cancer Inst, 1996; 88(21): 1529-1542.
33. Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group [Ｊ]. Lancet, 1998; 351(9114): 1451-1467.
34. Fisher B, Dignam J, Bryant J, et al. Five versus more than five years of tamoxifen for lymph node-negative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B-14 randomized trial [Ｊ]. J Natl Cancer Inst, 2001; 93(9): 684-690.
35. Aydiner A, Tas F. Meta-analysis of trials comparing anastrozole and tamoxifen for adjuvant treatment of postmenopausal women with early breast cancer [Ｊ]. Trials, 2008; 9: 47.
36. Crivellari D, Sun Z, Coates AS, et al. Letrozole compared with tamoxifen for elderly patients with endocrine-responsive early breast cancer: the BIG 1-98 trial [Ｊ]. J Clin Oncol, 2008; 26(12): 1972-1979.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Trend of Breast Cancer Treatment in 30 Years

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