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Risk and Mortality of Recurrent Breast Cancer in Stockholm 1985-2005

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Author Info

  • Jönsson, Bengt

    ()
    (Dept. of Economics, Stockholm School of Economics)

  • Lundkvist, Jonas

    (Karolinska Institutet)

  • Kasteng, Frida

    (European Health Economics)

  • Lidgren, Mathias

    (Karolinska Institutet)

  • Adolfsson, Jan

    (Onkologiskt Centraum, Karolinska University Hospital)

  • Bergh, Jonas

    (Radiumhemmet, Karolinska Institutet och University Hospital)

  • Fornander, Tommy

    (Dept of Oncology, Karolinska University Hospital at Södersjukhuset)

  • Wilking, Nils

    (Karolinska Institutet)

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    Abstract

    The purpose of this study was to estimate the risk and mortality of breast cancer recurrences in Swedish women, and to analyse changes over time and variations between patients in different risk groups. Such estimates are of key importance for modelling the cost-effectiveness of different strategies for adjuvant treatment of breast cancer. The study was based on all women diagnosed with breast cancer in Stockholm County between 1985 and 2005. Information about dates for locoregional recurrences, metastatic relapses, new contralateral tumours and death was collected. Cox proportional hazard and Weibull regression models were used to estimate survival functions, where year of diagnosis (dived into 5-year intervals), were included as explanatory variables in the models. The risk of recurrences has decreased during the last 20 years for all three types of recurrence; for metastatic relapse the 5-year risk was reduced from 12.9% to 6.0% from 1985-90 to 2000-2005 . Mortality has also been reduced, resulting in an increased 5-year survival from 52.6% to 64.1% after locoregional recurrence and from 10.4% to 15.5% for metastatic relapse. For contralateral tumours, with a 5-year survival rate of 74.6% in 1985-1990 and 78% 2000-2005, no significant increase was observed. Analysis of risk groups according to TNM classification showed large difference in the risk of metastatic breast cancer between the three defined groups, but small differences for the risk of locoregional recurrences and new contralateral tumours. The findings indicate that the early detection and new treatments have been successful in improving outcome for breast cancer patients and that it is important to use up-to-date information, when assessing the value of new treatment options.

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    Bibliographic Info

    Paper provided by Stockholm School of Economics in its series Working Paper Series in Economics and Finance with number 661.

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    Length: 19 pages
    Date of creation: 07 May 2007
    Date of revision:
    Handle: RePEc:hhs:hastef:0661

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    Postal: The Economic Research Institute, Stockholm School of Economics, P.O. Box 6501, 113 83 Stockholm, Sweden
    Phone: +46-(0)8-736 90 00
    Fax: +46-(0)8-31 01 57
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    Web page: http://www.hhs.se/
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    Related research

    Keywords: Breast cancer; Mortality; Survival; Recurrence; Sweden;

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