The French Early Breast Cancer Cohort (FRESH): A Resource for Breast Cancer Research and Evaluations of Oncology Practices Based on the French National Healthcare System Database (SNDS)

Abstract

Background: Breast cancer (BC) is the most frequent cancer and the leading cause of cancer-related death in women. The French National Cancer Institute has created a national cancer cohort to promote cancer research and improve our understanding of cancer using the National Health Data System (SNDS) and amalgamating all cancer sites. So far, no detailed separate data are available for early BC. Objectives: To describe the creation of the French Early Breast Cancer Cohort (FRESH). Methods: All French women aged 18 years or over, with early-stage BC newly diagnosed between 1 January 2011 and 31 December 2017, treated by surgery, and registered in the general health insurance coverage plan were included in the cohort. Patients with suspected locoregional or distant metastases at diagnosis were excluded. BC treatments (surgery, chemotherapy, targeted therapy, radiotherapy, and endocrine therapy), and diagnostic procedures (biopsy, cytology, and imaging) were extracted from hospital discharge reports, outpatient care notes, or pharmacy drug delivery data. The BC subtype was inferred from the treatments received. Results: We included 235,368 patients with early BC in the cohort (median age: 60 years). The BC subtype distribution was as follows: luminal (80.2%), triple-negative (TNBC, 9.5%); HER2+ (10.3%), or unidentifiable (n = 44,388, 18.9% of the cohort). Most patients underwent radiotherapy (n = 200,685, 85.3%) and endocrine therapy (n = 165,655, 70.4%), and 38.3% (n = 90,252) received chemotherapy. Treatments and care pathways are described. Conclusions: The FRESH Cohort is an unprecedented population-based resource facilitating future large-scale real-life studies aiming to improve care pathways and quality of care for BC patients.

New Real Dataset Creation to Develop an Intelligent System for Predicting Chemotherapy Protocols

“…This was observed in different fields including the medical one (e.g. [23], [24], [25]). Indeed, in the medical and health-care field, datasets are increasingly involved in planning and managing limited resources and to assist the decision-making process.…”

How Can the EU Beating Cancer Plan Help in Tackling Lung Cancer, Colorectal Cancer, Breast Cancer and Melanoma?

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“…BC is the most frequent cancer among French women and the leading cause of cancer-related death. National cancer plans have organised national screening (breast and colon cancer and recently cervical cancer), promoting prevention, rein-forcing care pathways, and improving life during and post-cancer [ 91 ].…”

Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database

“…Therefore the number of deaths is underestimated in this study. Although death due to early HER2+ breast cancer is rare (18-month survival of early breast cancer HER2+ patients is close to 100% 6 ), 70% of breast cancer deaths (all stages) occur at the hospital, 19 and 85% of breast cancer patients who die are admitted to the hospital during the last month of their life, it is possible that some treatment withdrawals are due to uncaptured death. In addition, other limitations are specific to this study.…”

“…In France, 10.3% of early breast cancer patients have HER2+ tumors. 6 As new drugs become available, the choice of treatment strategy is increasingly complex and patient-tailored. 7 To confirm and to complement clinical studies’ conclusions, it is essential to examine treatment sequences in the real-life setting.…”