Trends in breast cancer during three decades in Denmark: Stage at diagnosis, surgical management and survival

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Abstract
Background. Diagnostic and treatment of breast cancer has steadily improved in the last decades; mammography-screening, more aggressive axillary surgery and finally sentinel lymph node biopsies. This study analyses the impact of time trends in diagnostic and surgical procedures on stage at diagnosis and survival in three Danish counties in three decades. Methods. We compare extent of disease and outcome in three complete population-based patient cohorts with primary invasive breast cancer, diagnosed in 1986, 1996–1997 and 2002–2003; 3 385 patients, thereby comparing populations with and without centralised breast cancer management, mammography-screening, sentinel lymph node biopsies and the effect of time-period. Results. The 5-year over-all survival increased significantly (p Conclusion. During these three decades over-all survival of breast cancer improved. In the earlier periods we found survival differences according to residence, but in the late cohort there were no difference despite better stage distribution in the county with mammography-screening.