The curability of breast cancer.

Duncan, W; Kerr, G.R.

doi:10.1136/bmj.2.6039.781

Cited by 113 publications

(32 citation statements)

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“…In the studies on patients treated before our series, the relative risks were higher than those evidenced in our cohort and late mortality remained higher than that of the general population after a follow-up of at least 20 years (Table VII) [12,13]. In the studies on patients treated virtually during the same period as our series, late mortality attained that of the general population within 10Á20 years of follow-up [14,16]. However, other studies showed that late mortality remained higher than unity with follow-up not exceeding 20 years [17,28].…”

Section: Other Long-term Studiesmentioning

confidence: 66%

“…Some authors claim that longterm mortality could attain that observed in the general population, suggesting that patients could then be considered cured [14,19]. However, breast cancer loco-regional recurrences or metastases can arise decades after the initial treatment and some authors reported on excess mortality from breast cancer up to 40 years later among women younger than 40 at diagnosis [20].…”

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confidence: 99%

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Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

et al. 2008

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Section: Other Long-term Studiesmentioning

confidence: 66%

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confidence: 99%

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

et al. 2008

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“…Where long-term survival has been examined, it has mostly been shown that women with breast cancer continue to experience excess mortality into the second and third decades after their diagnosis (Duncan and Kerr, 1976;Langlands et al, 1979;Brinkley and Haybittle, 1984;Adami et al, 1986;Zahl and Tretli, 1997;Joensuu et al, 1999). This excess mortality may be due to the existence of 'micro-metastases' -disseminated cancer cells present even in women with apparently localised disease at diagnosis (Slade et al, 2005).…”

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confidence: 99%

Predicted trends in long-term breast cancer survival in England and Wales

et al. 2007

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“…For example, Figure 5 suggests that not only do as many as 89% of all testicular cancer patients diagnosed in 1982-84 survive beyond 5 years, but that those that do are no longer at any increased risk of death compared with the general population. For cancers such as breast cancer, in which there is no obvious levelling off in the cumulative relative survival rate before 10 years after diagnosis (Figure 7), the picture is less clear, and this has long been an area for discussion in the literature (Brinkley and Haybrittle, 1975;Duncan and Kerr, 1976;Langlands, 1995). In such cases, it is important to extend the estimates of cumulative relative survival to assess whether a certain proportion of patients ever reach a point at which they are no longer at an increased risk of death relative to the general population.…”

Section: Discussionmentioning

confidence: 99%

Estimating relative survival among people registered with cancer in England and Wales

et al. 1998

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One approach to assessing progress against cancer is to examine changes in the survival of cancer patients over time. Survival data for patients registered with cancer are compiled centrally by the Office for National Statistics (ONS) from information collected by regionally based cancer registries, and these data provide the main source of routine survival statistics for England and Wales. Although the ONS data include information on time from diagnosis to death, the specific cause of death is not routinely collected and so conventional estimates of survival based on these data reflect death from all causes rather than just the cancer of interest. Corresponding trends in survival estimates are sometimes difficult to interpret because it may be unclear whether changes in survival over time among a given group of cancer patients are in fact due to changes in the risk of death from the cancer itself, or to changes in the risk of death from causes other than that cancer.In situations like this, it is common to use some form of 'relative survival rate ' (Ederer et al, 1961) which is usually defined as a measure of survival 'corrected' for the effect of other independent causes of death, commonly referred to as background mortality.Although this approach appears simple in principle, there has been considerable debate in the statistical literature as to the correct choice of estimate, and it has been shown that use of certain estimates can lead to spurious results for long-term relative survival (Hakulinen, 1977). This paper aims to provide a straightforward introduction to the concept of relative survival and reviews some of the suggested methods for estimation. In particular, a simple person-years approach is described that is based on directly interpretable measures such as observed and expected numbers of deaths. This approach is illustrated using preliminary data from ONS on cancer survival in patients born after 1939 who were diagnosed with cancer during the period 1972-84. Materials and methodsThe concept of relative survival was devised to provide an objective measure of the proportion of patients dying from the direct or indirect consequence of a disease in a given population and, hence, a measure of survival corrected for the effect of other independent causes of death. The basic definition of the relative survival rate is given below.Let T d denote the time to death assuming that the subject is only at risk of death from the disease of interest, T e the time to death assuming that the subject is only at risk of death from all other causes, and T=minimum(T d ,T e ) the observed time to death, all measured from some suitable reference point such as date of diagnosis. Assuming that the cause of interest and all other causes are independent, the overall probability of surviving to time t is Summary Because routinely collected survival data for cancer patients in England and Wales do not typically specify cause of death, conventional estimates of survival in cancer patients based on such data are a measure of th...

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The curability of breast cancer.

Cited by 113 publications

References 3 publications

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

Long-term mortality in a cohort study of 6 800 French breast cancer patients treated between 1954 and 1983

Predicted trends in long-term breast cancer survival in England and Wales

Estimating relative survival among people registered with cancer in England and Wales

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