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NESS 2006 Annual Meeting
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Contemporary Analysis of Invasive Breast Cancer in Rhode Island, 1991-2005
Natalie G Coburn1, Emily M Clarke-Pearson2, Maureen A Chung2, Calvin H Law1, John Fulton3, Blake Cady2
1Division of Surgical Oncology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada2Rhode Island Hospital, Brown University, Providence, RI;3Rhode Island Department of Health, Providence, RI

Objective: Breast cancer detection by screening has lead to great improvements in the stage at presentation, treatment options, and survival. Recent reports suggest that a plateau in the size and stage at presentation may have occurred without significant improvement since the early 1990's. Rhode Island has historically had very high rates of screening mammography, so this plateau might be expected within our population.
Design: Cohort analysis
Setting: Rhode Island Cancer Registry
Patients: All female, invasive breast cancers in Rhode Island residents from the state cancer registry 1991-2005.
Main Outcome Measures: Cases compared by three five-year groups: 1991-1995 (n=3675), 1996-2000 (n=3922), 2001-2005 (n=3243). Cancer and patient factors were analyzed using Chi-squared and Fisher's exact tests.
Results: A significant decrease in age at diagnosis occurred. Mean tumor size decreased significantly over the entire time period and within the last two five-year groups. A shift to earlier stage at presentation and more differentiated tumors occurred. Three and five-year overall survival increased.
Statistically Significant Changes Over Time Periods
Time Periods 1991-1995 1996-2000 2001-2005
Age at Diagnosis (yrs)
Mean 64.6 64.6 63.1
Median 66.4 66.1 62.6
Mean Diameter (mm) 21.8 20.5 19.3
Diagnosed Stage I (%) 49% 52% 54%
Grade (differentiation)
Well 12% 16% 19%
Poor 49% 39% 35%
Survival (%)
3-year 80% 83% 85%
5-year 71% 75%

Conclusions: Despite high rates of mammography since the 1990's, significant improvements in age, size, stage and grade at breast cancer presentation have continued over the years 1991-2005 in Rhode Island.


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