title: Small but significant excess mortality compared with the general population for long-term survivors of breast cancer in the Netherlands.
abstract: BACKGROUND
  Coinciding with the relatively good and improving prognosis for patients with stage I-III breast cancer, late recurrences, new primary tumours and late side-effects of treatment may occur. We gained insight into prognosis for long-term breast cancer survivors.
  
  
  METHODS
  Data on all 205 827 females aged 15-89 diagnosed with stage I-III breast cancer during 1989-2008 were derived from the Netherlands Cancer Registry. Conditional 5-year relative survival was calculated for every subsequent year from diagnosis up to 15 years.
  
  
  RESULTS
  For stage I, conditional 5-year relative survival remained ~95% up to 15 years after diagnosis (a stable 5-year excess mortality rate of 5%). For stage II, excess mortality remained 10% for those aged 15-44 or 45-59 and 15% for those aged 60-74. For stage III, excess mortality decreased from 35% at diagnosis to 10% at 15 years for those aged 15-44 or 45-59, and from ~40% to 30% for those aged ≥60.
  
  
  CONCLUSIONS
  Patients with stage I or II breast cancer had a (very) good long-term prognosis, albeit exhibiting a small but significant excess mortality at least up to 15 years after diagnosis. Improvements albeit from a lower level were mainly seen for patients who had been diagnosed with stage III disease. Caregivers can use this information to better inform (especially disease-free) cancer survivors about their actual prognosis.
authors.affiliation: Department of Research, Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven.
authors.forename: M L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: L N
authors.initials: LN
authors.lastname: van Steenbergen
authors.forename: A C
authors.initials: AC
authors.lastname: Voogd
authors.forename: V C G
authors.initials: VC
authors.lastname: Tjan-Heijnen
authors.forename: P H
authors.initials: PH
authors.lastname: Nijhuis
authors.forename: P M
authors.initials: PM
authors.lastname: Poortmans
authors.forename: J W W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: D J
authors.initials: DJ
authors.lastname: van Spronsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D016019:Survival Analysis; D017741:Survivors; D055815:Young Adult
keywords: breast cancer; conditional survival; excess mortality; late side-effects; long-term survivors