Trends in patient characteristics, treatment and survival in breast cancer in a non-selected retrospective clinical cohort study of 2,600 patients

Breast cancer epidemiology and survival recently saw major changes resulting from improved screening and treatment modalities. This paper aims to provide an overview of changes in recent years in patient characteristics and treatment procedures. Using data from BRENDA, an unselected cohort with universal coverage of a constant catchment area over a 13-year observation period, this study provides an overview of key trends. Beside steady increases in overall and disease-free survival, main trends in recent years included a gradual increase in new patients' average ages. Grading, but not T stages, improved. Node negative, endocrine responsive patient shares increased; node positive, endocrine responsive shares decreased. HER2neu screening went from uncommon to ubiquitous. Sentinel node biopsy reduced excised numbers of lymph nodes. Second and third generation chemotherapies replaced CMF. Neoadjuvant therapy was gradually introduced. Aromatase inhibitors pushed down Tamoxifen use. 90 % of endocrine responsive patients now receive endocrine therapy. Our results suggest that improved survival only partially results from improved prognostic factors, but rather seems mainly due to improved treatment modalities. Treatment procedures have changed dramatically over recent years. This was associated with steady increases in favorable outcomes among patients.