title: A French national survey on infiltrating breast cancer: analysis of clinico-pathological features and treatment modalities in 1159 patients.
abstract: BACKGROUND
  Despite the approximate 42,000 yearly new cases of breast cancer in France, there have been very few exhaustive studies on the clinicopathological features and treatment options of this disease.
  
  
  METHODS
  Thus, a prospective, non-selective, nationwide survey on infiltrating breast cancer (IBC) was conducted in France from September 2001 to April 2002, in order to assess the epidemiological features of newly diagnosed disease, the prognostic and predictive variables with a special emphasis on hormone receptors, and the current approaches to therapy in everyday clinical practice.
  
  
  RESULTS
  In total, 1159 patients were evaluable (median age 57 years); two-thirds of women were postmenopausal and 38% had undergone hormonal replacement therapy (HRT). Ductal and lobular infiltrating cancers represented 82.3% and 11.6% of cases, respectively. Most tumours expressed oestrogen (79.7%) and progesterone (69.7%) receptors. Overexpression of the human epidermal growth factor receptor-2 oncogene was found in 20.6% of the assessed cases. IBC diagnosed in women under HRT presented significantly better clinico-pathological features than in non-users. All patients underwent surgery as first treatment: 77.5% breast-conserving surgery (BCS) and 22.5% mastectomy; 1024 patients also underwent axillary surgery. The overall axillary lymph-node involvement rate was 44.4%. Radiotherapy was proposed in 98% and 83% of the women who had undergone BCS and mastectomy, respectively. Adjuvant chemotherapy was delivered in 58.7% of patients and hormonal treatment was provided in 76.5% of patients; tamoxifen was the most widely used hormonal treatment.
  
  
  CONCLUSIONS
  This study showed a trend for global downstaging of IBC (with favourable clinico-pathological features), leading to a high rate of BCS. Postoperative treatments were widely used, in accordance with national and international guidelines. Use of aromatase inhibitors and taxanes was limited, but is likely to rise in the future.
authors.affiliation: Department of Oncology and Radiotherapy, Polyclinique de Courlancy, Reims, France. b.cutuli@wanadoo.fr
authors.forename: Bruno
authors.initials: B
authors.lastname: Cutuli
authors.forename: Paul Henri
authors.initials: PH
authors.lastname: Cottu
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Guastalla
authors.forename: Hubert
authors.initials: H
authors.lastname: Mechin
authors.forename: Anne
authors.initials: A
authors.lastname: Costa
authors.forename: Rosemary
authors.initials: R
authors.lastname: Jourdan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D018275:Carcinoma, Lobular / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D015914:Estrogen Replacement Therapy; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008408:Mastectomy; D008593:Menopause; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D015996:Survival Rate
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone