Breast-conserving therapy is better than mastectomy: Based on registry data from Norway
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AbstractPaper I shows the benefit of BCT compared with mastectomy for women with early stage breast cancer. The adjust-ed analysis shows that women who underwent mastectomy had a HR of 1.64 (95% CI: 1.43-1.88) for breast cancer death compared to women who underwent BCT with RT. Paper II shows the survival benefit of BCT compared to mastectomy in stage T1N1N0 for women participating in the Norwegian mammography screening programme, but not for the other early stages of breast cancer. Women with T1N1N0 who underwent mastectomy had an HR of 2.91 (95% CI: 1.30–6.48) for breast cancer death compared to women who underwent BCT. This study indicates increased survival benefit of BCT compared with mastectomy with increasing severity of breast cancer. A better immune re-sponse in women undergoing BCT compared to mastectomy is discussed as a hypothesis. Detailed information on diagnosis, treatment and follow-up is needed to identify a cause that may explain the find-ings in Articles I and II. To increase and motivate fore data collection, article III describes how submitted data to the cancer registry can be used for European certification of hospitals that treat breast cancer in Norway.
List of papers
|Paper I: Survival is better after breast-conserving therapy than mastectomy for early stage breast cancer: a registry-based follow-up study of Norwegian women primary operated between 1998 and 2008. Hartmann-Johnsen OJ, Kåresen R, Schlichting E, Nygård JF. Annals of surgical oncology (2015) 22:3836–3845. DOI 10.1245/s10434-015-4441-3. The article is included in the thesis. Also available at https://doi.org/10.1245/s10434-015-4441-3|
|Paper II: Better survival after breast-conserving therapy compared to mastectomy, when axillary node status is positive in early stage breast cancer: a registry-based followup study of 6,387 Norwegian women participating in screening, primarily operated between 1998 and 2009. Hartmann-Johnsen OJ, Kåresen R, Schlichting E, Nygård JF. World Journal of Surgical Oncology (2017) 15:118. DOI 10.1186/s12957-017-1184-6. The article is included in the thesis. Also available at https://doi.org/10.1186/s12957-017-1184-6|
|Paper III: Development of the Clinical Quality Registry for Breast Cancer in Norway. Hartmann-Johnsen OJ, Kåresen R, Schlichting E, Naume B, Nygård JF. International Journal of Medical Informatics 125 (2019) 102–109. DOI 10.1016/j.ijmedinf.2019.03.004. The paper is included in the thesis. Also available at https://doi.org/10.1016/j.ijmedinf.2019.03.004|