TABLE 1.
Period of diagnosis | 1989 to 1992 | 1993 to 1996 | 1997 to 2000 | 2001 to 2004 | 2005 to 2008 | 2009 to 2012 | 2013 to 2017 | Total | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | N | % | N | % | N | % | N | % | |
Age at diagnosis | ||||||||||||||||
Median | 61.7 | 61.0 | 60.1 | 59.2 | 59.7 | 60.5 | 61.4 | 60.5 | ||||||||
Range | 21.8 to 100.3 | 20.4 to 107.3 | 18.7 to 104.2 | 18.7 to 100.4 | 18.9 to 102.1 | 19.2 to 103.1 | 18.5 to 103.8 | 18.5 to 107.3 | ||||||||
<40 | 2364 | 7.3 | 2463 | 6.6 | 2519 | 6.2 | 2829 | 6.4 | 2682 | 5.7 | 2660 | 5.2 | 3378 | 5.1 | 18 895 | 5.9 |
40 to 49 | 6085 | 18.8 | 7028 | 18.8 | 7639 | 18.8 | 8423 | 18.9 | 8986 | 19.0 | 9160 | 17.9 | 10 880 | 16.3 | 58 201 | 18.2 |
50 to 74 | 17 547 | 54.1 | 20 492 | 54.8 | 22 223 | 54.7 | 24 949 | 56.0 | 27 385 | 57.9 | 30 789 | 60.3 | 41 930 | 62.7 | 185 315 | 57.9 |
≥75 | 6440 | 19.9 | 7444 | 19.9 | 8265 | 20.3 | 8333 | 18.7 | 8215 | 17.4 | 8450 | 16.5 | 10 691 | 16.0 | 57 838 | 18.1 |
Tumour stage | ||||||||||||||||
I | 9992 | 31.4 | 13 348 | 36.6 | 14 972 | 37.5 | 16 558 | 37.6 | 18 848 | 40.1 | 22 816 | 44.8 | 31 212 | 46.7 | 127 746 | 40.3 |
II | 16 505 | 51.8 | 17 863 | 49.0 | 19 430 | 48.7 | 20 107 | 45.7 | 19 114 | 40.7 | 19 046 | 37.4 | 24 688 | 37.0 | 136 753 | 43.1 |
III | 3282 | 10.3 | 3282 | 9.0 | 3401 | 8.5 | 5211 | 11.8 | 6814 | 14.5 | 6673 | 13.1 | 7255 | 10.9 | 35 918 | 11.3 |
IV | 2083 | 6.5 | 1996 | 5.5 | 2103 | 5.3 | 2145 | 4.9 | 2236 | 4.8 | 2344 | 4.6 | 3633 | 5.4 | 16 540 | 5.2 |
Unknown | 574 | 938 | 740 | 513 | 256 | 180 | 91 | 3292 | ||||||||
Tumour size a | ||||||||||||||||
T1 | 14 190 | 45.2 | 18 101 | 50.2 | 20 640 | 52.3 | 23 797 | 54.6 | 26 702 | 57.2 | 30 041 | 59.5 | 40 559 | 61.2 | 174 030 | 55.4 |
T2 | 12 741 | 40.6 | 13 491 | 37.4 | 14 387 | 36.5 | 15 852 | 36.3 | 16 264 | 34.9 | 16 587 | 32.9 | 20 126 | 30.3 | 109 448 | 34.9 |
T3 | 1617 | 5.1 | 1608 | 4.5 | 1616 | 4.1 | 1738 | 4.0 | 1886 | 4.0 | 2125 | 4.2 | 3346 | 5.0 | 13 936 | 4.4 |
T4 | 2866 | 9.1 | 2835 | 7.9 | 2820 | 7.1 | 2232 | 5.1 | 1793 | 3.8 | 1737 | 3.4 | 2291 | 3.5 | 16 574 | 5.3 |
Unknown | 1022 | 1392 | 1183 | 915 | 623 | 569 | 557 | 6261 | ||||||||
Lymph node status a | ||||||||||||||||
N0 | 17 679 | 56.8 | 21 621 | 60.2 | 23 032 | 59.0 | 24 682 | 57.1 | 27 959 | 60.1 | 31 518 | 62.3 | 44 087 | 66.3 | 190 578 | 60.9 |
N1 | 12 708 | 40.8 | 13 640 | 38.0 | 15 427 | 39.5 | 15 247 | 35.3 | 12 959 | 27.8 | 13 849 | 27.4 | 17 742 | 26.7 | 101 572 | 32.5 |
N2 | 659 | 2.1 | 590 | 1.6 | 528 | 1.4 | 2125 | 4.9 | 3440 | 7.4 | 3052 | 6.0 | 2545 | 3.8 | 12 939 | 4.1 |
N3 | 104 | 0.3 | 49 | 0.1 | 59 | 0.2 | 1165 | 2.7 | 2199 | 4.7 | 2183 | 4.3 | 2159 | 3.2 | 7918 | 2.5 |
Unknown | 1286 | 1527 | 1600 | 1315 | 711 | 457 | 346 | 7242 | ||||||||
Histological grade b | ||||||||||||||||
Grade 1 | 1022 | 8.1 | 1611 | 10.3 | 4248 | 16.1 | 6988 | 19.4 | 9196 | 22.7 | 10 295 | 24.3 | 14 031 | 24.5 | 47 391 | 20.6 |
Grade 2 | 4207 | 33.5 | 5824 | 37.3 | 11 179 | 42.3 | 16 202 | 45.0 | 18 032 | 44.5 | 19 275 | 45.6 | 28 176 | 49.2 | 102 895 | 44.6 |
Grade 3 | 7330 | 58.4 | 8163 | 52.3 | 10 997 | 41.6 | 12 833 | 35.6 | 13 249 | 32.7 | 12 723 | 30.1 | 15 027 | 26.3 | 80 322 | 34.8 |
Unknown | 19 877 | 21 829 | 14 222 | 8511 | 6791 | 8766 | 9645 | 89 641 | ||||||||
ER‐status | ||||||||||||||||
Positive | 37 675 | 81.7 | 41 961 | 83.9 | 55 964 | 84.7 | 135 600 | 83.6 | ||||||||
Negative | 8433 | 18.3 | 8073 | 16.1 | 10 116 | 15.3 | 26 622 | 16.4 | ||||||||
Unknown | 1160 | 1025 | 799 | 2984 | ||||||||||||
PR‐status | ||||||||||||||||
Positive | 29 126 | 65.9 | 33 193 | 67.5 | 45 736 | 69.3 | 108 055 | 67.8 | ||||||||
Negative | 15 104 | 34.1 | 16 011 | 32.5 | 20 269 | 30.7 | 51 384 | 32.2 | ||||||||
Unknown | 3038 | 1855 | 874 | 5767 | ||||||||||||
HER2‐status | ||||||||||||||||
Positive | 6435 | 15.3 | 6892 | 14.3 | 8766 | 13.7 | 22 093 | 14.3 | ||||||||
Negative | 35 617 | 84.7 | 41 291 | 85.7 | 55 143 | 86.3 | 132 051 | 85.7 | ||||||||
Unknown | 5216 | 2876 | 2970 | 11 062 | ||||||||||||
Receptor subtype c | ||||||||||||||||
HR+/HER2− | 30 594 | 73.4 | 35 865 | 74.8 | 48 453 | 75.9 | 114 912 | 74.9 | ||||||||
HR+/HER2+ | 3929 | 9.4 | 4481 | 9.3 | 5843 | 9.2 | 14 253 | 9.3 | ||||||||
HR−/HER2+ | 2384 | 5.7 | 2329 | 4.9 | 2908 | 4.6 | 7621 | 5.0 | ||||||||
HR−/HER2− | 4765 | 11.4 | 5287 | 11.0 | 6652 | 10.4 | 16 704 | 10.9 | ||||||||
Unknown | 5596 | 3097 | 3023 | 11 716 | ||||||||||||
Surgery + radiotherapy d | ||||||||||||||||
BCS + RT | 8480 | 26.1 | 12 749 | 34.1 | 15 315 | 37.7 | 19 608 | 44.0 | 22 796 | 48.2 | 25 494 | 49.9 | 36 977 | 55.3 | 141 419 | 44.2 |
BCS + no RT | 486 | 1.5 | 781 | 2.1 | 1028 | 2.5 | 847 | 1.9 | 712 | 1.5 | 754 | 1.5 | 1256 | 1.9 | 5864 | 1.8 |
Mastectomy + RT | 4433 | 13.7 | 5653 | 15.1 | 6041 | 14.9 | 6063 | 13.6 | 5910 | 12.5 | 6276 | 12.3 | 8579 | 12.8 | 42 955 | 13.4 |
Mastectomy + no RT | 7609 | 23.5 | 13 662 | 36.5 | 14 591 | 35.9 | 14 105 | 31.7 | 13 518 | 28.6 | 13 715 | 26.9 | 13 215 | 19.8 | 90 415 | 28.2 |
Surgery (unspecified) + RT | 3855 | 11.9 | 500 | 1.3 | 32 | 0.1 | 13 | 0.0 | 5 | 0.0 | 2 | 0.0 | 3 | 0.0 | 4410 | 1.4 |
Surgery (unspecified) + no RT | 4416 | 13.6 | 610 | 1.6 | 82 | 0.2 | 11 | 0.0 | 3 | 0.0 | 4 | 0.0 | 8 | 0.0 | 5134 | 1.6 |
No surgery + RT | 730 | 2.3 | 574 | 1.5 | 412 | 1.0 | 395 | 0.9 | 302 | 0.6 | 263 | 0.5 | 295 | 0.4 | 2971 | 0.9 |
No surgery + no RT | 2427 | 7.5 | 2898 | 7.7 | 3145 | 7.7 | 3492 | 7.8 | 4022 | 8.5 | 4551 | 8.9 | 6546 | 9.8 | 27 081 | 8.5 |
Chemotherapy | ||||||||||||||||
Taxane‐containing CT e | 4 | 0.0 | 8 | 0.0 | 68 | 0.2 | 159 | 0.4 | 3589 | 7.6 | 5947 | 11.6 | 3175 | 4.7 | 12 950 | 4.0 |
Anthracycline‐containing CT f | 6 | 0.0 | 26 | 0.1 | 125 | 0.3 | 3673 | 8.2 | 3299 | 7.0 | 2016 | 3.9 | 1195 | 1.8 | 10 340 | 3.2 |
Taxane‐ and anthracycline‐ containing CT g | 0 | 0.0 | 0 | 0.0 | 6 | 0.0 | 127 | 0.3 | 2297 | 4.9 | 10 521 | 20.6 | 22 024 | 32.9 | 34 975 | 10.9 |
CT (other/unspecified) h | 4329 | 13.3 | 5483 | 14.6 | 9849 | 24.2 | 11 245 | 25.3 | 8804 | 18.6 | 4029 | 7.9 | 306 | 0.5 | 44 045 | 13.8 |
No CT | 28 097 | 86.6 | 31 910 | 85.3 | 30 598 | 75.3 | 29 330 | 65.9 | 29 279 | 61.9 | 28 546 | 55.9 | 40 179 | 60.1 | 217 939 | 68 |
Endocrine therapy i | ||||||||||||||||
Tamoxifen first | 18 | 0.1 | 38 | 0.1 | 143 | 0.4 | 9649 | 21.7 | 21 043 | 44.5 | 26 104 | 51.1 | 29 774 | 44.5 | 86 769 | 27.1 |
Aromatase inhibitors first | 0 | 0.0 | 1 | 0.0 | 2 | 0.0 | 863 | 1.9 | 2335 | 4.9 | 3999 | 7.8 | 8950 | 13.4 | 16 150 | 5.0 |
Ovarian ablation j | 9 | 0.0 | 91 | 0.2 | 194 | 0.5 | 184 | 0.4 | 118 | 0.2 | 113 | 0.2 | 186 | 0.3 | 895 | 0.3 |
ET (other/unspecified) k | 9708 | 29.9 | 11 436 | 30.6 | 14 630 | 36.0 | 9145 | 20.5 | 0 | 0.0 | 0 | 0.0 | 4 | 0.0 | 44 923 | 14.0 |
No endocrine therapy | 22 701 | 70.0 | 25 861 | 69.1 | 25 677 | 63.2 | 24 693 | 55.4 | 23 772 | 50.3 | 20 843 | 40.8 | 27 965 | 41.8 | 171 512 | 53.6 |
Systemic therapy | ||||||||||||||||
Chemotherapy only | 3829 | 11.8 | 4670 | 12.5 | 6683 | 16.4 | 6490 | 14.6 | 4448 | 9.4 | 4633 | 9.1 | 5598 | 8.4 | 36 351 | 11.4 |
Endocrine therapy only | 9225 | 28.4 | 10 719 | 28.6 | 11 604 | 28.5 | 11 191 | 25.1 | 11 747 | 24.9 | 14 436 | 28.3 | 20 616 | 30.8 | 89 538 | 28.0 |
Chemotherapy and endocrine therapy | 510 | 1.6 | 847 | 2.3 | 3365 | 8.3 | 8605 | 19.3 | 9843 | 20.8 | 12 965 | 25.4 | 14 105 | 21.1 | 50 240 | 15.7 |
Targeted therapy l | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 115 | 0.3 | 3751 | 7.9 | 5075 | 9.9 | 7220 | 10.8 | 16 161 | 5.0 |
No systemic therapy | 18 872 | 58.2 | 21 191 | 56.6 | 18 994 | 46.7 | 18 133 | 40.7 | 17 479 | 37.0 | 13 950 | 27.3 | 19 340 | 28.9 | 127 959 | 40.0 |
Total | 32 436 | 100.0 | 37 427 | 100.0 | 40 646 | 100.0 | 44 534 | 100.0 | 47 268 | 100.0 | 51 059 | 100.0 | 66 879 | 100.0 | 320 249 m | 100.0 |
Abbreviations: AI, aromatase inhibitor; BCS, breast‐conserving surgery; CT, chemotherapy; ET, endocrine therapy; ER, oestrogen receptor; HER2, human epidermal growth factor receptor2; HR, hormone receptor; NCR, Netherlands Cancer Registry; PR, progesterone receptor; RT, radiotherapy.
Note: The various elements included in the table were collected by the NCR at different moments in time. ER status and PR status were routinely collected and included in the NCR since 2005 and HER2 status since 2006. Specification of chemotherapy and endocrine therapy regimens in the NCR has been done since 2003. Target therapy was routinely collected and included in the NCR since 2005 (mainly trastuzumab). Treatment data in the NCR are collected up to 1 year after initial cancer diagnosis. The data may still include 162 in situ BC cases due to discrepancies in registration within the dataset. Percentages may not total to 100% due to rounding.
Tumour size and lymph node status are based on the pathological stage, but clinical stage was used if pathological stage was unavailable.
Including 502 first primary BCs that were defined as “undifferentiated” in the NCR.
HR+ = ER+ and/or PR+, HR− = ER− and PR−.
Patients that received both BCS and mastectomy were included in the mastectomy group.
The chemotherapy regimen contains taxanes, but no anthracyclines.
The chemotherapy regimen contains anthracyclines, but no taxanes.
The chemotherapy regimen contains both taxanes and anthracyclines.
All other chemotherapy regimens (eg, cyclophosphamide/cisplatin‐containing regimes) and/or chemotherapy not further specified.
The NCR codes aromatase inhibitors specifically; tamoxifen is coded as endocrine treatment. Both treatments were included when provided as initial treatment.
Ovarian ablation includes LHRH agonist treatment, radiotherapy and/or surgical removal of the ovaries to reduce oestrogen production in premenopausal women.
All other endocrine treatments (eg, fulvestrant) and/or not further specified.
Patients received targeted therapy either alone or in combination with CT, ET or both.
Total numbers provided do not correspond with those for the ER, PR, HER2 and the receptor subtype groups due to their inclusion since 2005 to 2009.