gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Trends in breast cancer survival in Germany from 1976 to 2008 – A period analysis by age and stage

Meeting Abstract

  • Bernd Holleczek - Saarland Cancer Registry, Saarbrücken
  • Volker Arndt - German Cancer Research Center, Division for Clinical Epidemiology and Aging Research, Heidelberg
  • Christa Stegmaier - Saarland Cancer Registry, Saarbrücken
  • Hermann Brenner - German Cancer Research Center, Division for Clinical Epidemiology and Aging Research, Heidelberg

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds190

doi: 10.3205/11gmds190, urn:nbn:de:0183-11gmds1905

Published: September 20, 2011

© 2011 Holleczek et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Implementation of mammography screening and advances in breast cancer treatment are considered as main reasons for the decline in breast cancer mortality observed in many industrialized countries during the past two decades. The purpose of this study was to assess most recent 5-year relative survival of patients with invasive BRC and precedent trends stratified by age and tumour stage in Saarland (Germany). Patterns are discussed along with BRC incidence (including in-situ tumours) and mortality in the context of screening activities and advances in treatment of primary invasive BRC.

Methods: Data from the population based Saarland Cancer Registry including patients diagnosed with breast cancer from 1972 to 2007 were used. Mortality follow-up was available until end of 2008. Age-standardized rates using the Europe standard population were derived for incidence of invasive and in-situ tumours and BRC mortality for successive calendar periods of four years. Period analysis was employed to calculate up-to-date 5-year relative survival trends.

Results: Mortality started to decline during the 1990s, and a previous increase in incidence levelled off in the early 21st century. Overall age-standardized 5-year relative survival of invasive breast cancer steadily increased during the past three decades from 61% in calendar period 1977-80 over 73% in 1992-96 to 83% in 2004-08. This increase was mostly due to an increase in survival for patients with localized cancers and locally or regionally spread tumours (increase of age-standardized 5-year relative survival from 92% to 98% and from 65% to 80%, respectively, between 1992 and 2008), whereas age-standardized 5-year relative survival essentially remained unchanged at levels close to 21% in patients with metastasized cancer. For women aged 70 years or older 5-year relative survival and its increase over time were inferior compared to younger patients.

Conclusions: The observed trends in population based survival suggest that advances in treatment of early breast cancer have substantially contributed to the gain in prognosis. The poor prognosis of metastasized breast cancer patients, who did not benefit from improved survival despite interim advances in treatment options, and the increasing age gradient in 5- year relative survival call for enhanced efforts for early detection and more rigorous treatment of elderly patients.


Holleczek B, Arndt V, Stegmaier C, Brenner H. Trends in breast cancer survival in Germany from 1976 to 2008. —A period analysis by age and stage. Cancer Epidemiol. in press. DOI: 10.1016/j.canep.2011.01.008 External link