Researchers find clues to improve breast cancer survival
Checking lymph nodes during surgery and assessing the hormone status of tumours
could help improve breast cancer survival in the UK, according to research published
today in Annals of Oncology.
In a study of over 9,000 breast cancer patients at 10 hospitals in the East
of England researchers found that hospitals with a better average survival were
those where surgeons checked lymph nodes during surgery in more than 90% of
Professor Stephen Duffy, Cancer Research UK professor of screening and study
"We found that the proportion of women under 70 who had lymph node
checks as recommended by NICE ranged from 81% to 94% with the hospitals with
higher percentages having better survival."
The study also found that, for women over 70, having surgery to remove their
tumour and checking the hormone type were the two main factors which explained
survival differences between hospitals.
The hospitals showing better survival in the over 70s were those which assessed
the hormone receptor status in more of their patients.
The team of researchers from London and Cambridge compared breast cancer survival
rates between 10 different hospitals across eastern England.
For women under 70 the five year relative survival rates ranged from 85 to
90%. And for those over 70 the survival rate was between 65 and 75%.
The figures are close to the highest rates in Europe but the researchers believe
that survival could be even better if all hospitals closely followed the existing
Professor Duffy continued:
"Although survival rates for breast cancer are very good in hospitals
we studied in the East of England, rivalling the best in Europe, we have found
that there is still room for improvement.
One reason why survival varied between the hospitals for women under
70 was whether they had their lymph nodes removed and examined. Another is
screening as we know from previous studies that women have a much better chance
of survival if their tumour is picked up at an early stage. We would encourage
all women to attend screening when invited."
The researchers also found that more women older than 70 are surviving the
disease if they have surgery. Another important factor for this group of women
was whether the cancer's hormone type was assessed at diagnosis. The researchers
believe that with more hospitals following the guidelines on hormone receptor
typing, there would be further improvements in survival.
Professor Gordon Wishart, the leading author on the study said:
"Lymph node staging and hormone receptor typing give valuable information
to decide on optimal treatment after surgery. As more hospitals follow current
professional guidelines and carry out these investigations, more effective
treatment will follow and patient survival is likely to improve even further."
Professor Peter Johnson, Cancer Research UK's chief clinician, said:
"It's very encouraging to see that at their best, results from
the UK are the equal of those in Europe. The real challenge is to make sure
that consistently high standards are met in all hospitals, so that every patient
can benefit from the significant improvements in survival we have made."