Improvement in the prognosis of Japanese breast cancer patients from 1946 to 2001--an institutional review.
BACKGROUND
Breast cancer has emerged as one of the most frequent malignancies among Japanese women; however, the long-term survival of Japanese breast cancer patients is uncertain.


METHODS
We analyzed the chronological changes in the clinical and pathological characteristics, treatment procedures and the long-term prognosis of 15 416 Japanese women with 16 217 primary breast cancers treated in the Cancer Institute Hospital in Tokyo between 1946 and 2001.


RESULTS
Our analysis revealed a chronological increase in the mean patient age, postmenopausal patients and non-invasive carcinomas. Operative procedures became less extensive, with approximately 45% of breast cancer patients in 2000-2001 receiving breast-conserving treatment. Radiotherapy to the regional lymph nodes decreased, while postoperative chemotherapy and hormonal treatments have become more frequent. The survival rate has improved steadily during the past 5 decades. The 10-year crude overall survival rate improved from 61% before 1960 to 83% in the 1990s.


CONCLUSIONS
The survival rate of Japanese women with breast cancer has dramatically improved during the past 5 decades.
Yoshimoto
Masataka
M
Department of Breast Surgery, Cancer Institute Hospital, Kami-Ikebukuro 1-37-1, Toshima-ku, Tokyo 170-8455, Japan. myoshimoto@jfcr.or.jp
Tada
Keiichiro
K
Hori
Haruko
H
Morota
Akira
A
Tanabe
Masahiko
M
Nishimura
Seiichiro
S
Takahashi
Kaoru
K
Makita
Masujiro
M
Iwase
Takuji
T
Kasumi
Fujio
F
Takahashi
Syunji
S
Ito
Yoshinori
Y
Oguchi
Masahiro
M
Yamashita
Takashi
T
Akiyama
Futoshi
F
Sakamoto
Goi
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods / Q000706:statistics & numerical data*; D008593:Menopause; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal