PTNM STAGE DISTRIBUTION IN BREAST-CANCER - A POPULATION-BASED SURVEY IN NORTHERN ITALY

Aims and Background: The role of distribution by stage at diagnosis in breast cancer has been considered in many studies, with particular re gard to evaluation of prognosis, impact of screening programs and qual ity of care. Nevertheless, international comparisons of descriptive da ta can be hampered by lack of homogeneity in staging methods. The TNM is presently the most common staging system used all over the world, a lthough some criticism have been raised recently against its pragmatic value. The present study reports a population-based survey of patholo gic TNM distribution in incident cases of female breast cancer in the Verona province, a geographical area of northern Italy covered by canc er registration. Methods: All histologically proven incident cases of breast cancer were identified in the study period 1988-1990 and classi fied as for tumor size and nodal involvement according to the patholog ical TNM criteria. The type of surgical treatment was also registered for all cases diagnosed in 1990. Results: one thousand two hundreds an d fifty-four invasive and in situ breast cancers were observed and pT1 cases accounted for 44.4%. Nodal involvement was present in 41.5% of invasive cancers. A surgical treatment was performed in 1213 patients (96.7%). Axillary dissection was reported in 1080 cases, 820 of them ( 76.6%) having 10 or more lymph nodes examined. Radical mastectomy acco unted for 74% of the 458 breast cancers diagnosed in 1990 and 31.6% of the eligible cases were conservatively treated. Conclusions: Cancer r egistries should be encouraged to report data on stage distribution in breast cancer (and in other malignancies). This practice could improv e international comparisons and give an essential contribution to stud ies on survival, screening programs and quality of care.