Impact of experience in breast cancer surgery on survival: the role of quality of care in a registry-based cohort.

Aims Of The Study: Previous studies have suggested that the surgeon's experience in breast cancer surgery may affect patient survival. In this registry-based retrospective cohort study, we examined whether quality of care could partly explain this association.

Methods: All invasive breast cancers operated on in the private sector between 2000 and 2009 were identified in the Geneva Cancer Registry and followed up for 5 years.

Determinants of genetic counseling uptake and its impact on breast cancer outcome: a population-based study.

Genetic counseling and BRCA1/BRCA2 genes testing are routinely offered in a clinical setting. However, no data are available on the proportion of breast cancer patients with a positive family history undergoing genetic counseling. By linking databases of the Oncogenetics and Cancer Prevention Unit at the Geneva University Hospitals and the population-based Geneva Cancer Registry, we evaluated the uptake of genetic counseling among 1709 breast cancer patients with familial risk of breast cancer and the determinants of such a consultation process.

Impact of family history of breast cancer on tumour characteristics, treatment, risk of second cancer and survival among men with breast cancer.

Background: Male breast cancer patients have a higher risk of developing a second primary cancer, but whether this risk differs according to the family history of breast or ovarian cancers remains to be elucidated. We aimed to determine the effect of a positive family history among men diagnosed with breast cancer on tumour characteristics, treatment, second cancer occurrence and overall survival.

Methods: We included 46 patients with known information on the family history of breast or ovarian cancer recorded at the Geneva Cancer Registry between 1970 and 2009.

Lung cancer mortality risk among breast cancer patients treated with anti-estrogens.

Background: The Women's Health Initiative randomized clinical trial reported that menopausal hormone therapy increases lung cancer mortality risk. If this is true, use of anti-estrogens should be associated with decreased lung cancer mortality risk. The authors compared lung cancer incidence and mortality among breast cancer patients with and without anti-estrogen therapy.

Risk of second breast cancer according to estrogen receptor status and family history.

A recent study reported an increased risk of contralateral estrogen-negative breast cancer after a first primary estrogen-negative breast cancer. Our study aims to confirm this result and to evaluate how the risk of second breast cancer occurrence is affected by family history of breast cancer and anti-estrogen treatment. We included all 4,152 women diagnosed with breast cancer between 1995 and 2007, using data from the population-based Geneva Cancer Registry.

Incidental detection of synchronous primary tumours during staging workup for prostate cancer.

Questions Under Study: To assess the prevalence of incidental synchronous primary cancers discovered by abdominal CT scan among prostate cancer patients.

Methods: Patients with prostate cancer in Geneva, Switzerland, were retrospectively analysed regarding incidental diagnosis of synchronous second primary malignancies, including a cohort of 398 patients treated from 1991 through 2001 with radical radiotherapy (RT) and a second cohort of 419 patients treated from 1991 through 2001 by radical prostatectomy (RP) in order to analyse the differences between RT and RP patients. Both cohorts were evaluated regarding incidence of synchronous second primary cancers, compared with that expected in the general population (Standardized Incidence Ratio, SIR).

Impact of socioeconomic status on prostate cancer diagnosis, treatment, and prognosis.

Background: The objective of the current study was to evaluate the impact of socioeconomic disparities on prostate cancer presentation, treatment, and prognosis in Geneva, Switzerland, in which healthcare costs, medical coverage, and life expectancy are considered to be among the highest in the world.

Methods: This population-based study included all patients diagnosed with invasive prostate cancer among the resident population between 1995 and 2005. Patients were divided into 3 socioeconomic groups according to their last known occupation.

Changing pattern of age-specific breast cancer incidence in the Swiss canton of Geneva.

Hormone replacement therapy (HRT) use declined sharply after mid-2002, when the Women's Health Initiative trial reported an association between breast cancer occurrence and HRT. Hypothesized mechanism behind this association is that HRT promotes growth of pre-existing small tumors, leading to earlier tumor detection. We evaluated the impact of the sudden decline in HRT use on age distribution of breast cancer in Geneva.

Survival according to the site of bronchial microscopic residual disease after lung resection for non-small cell lung cancer.

Objective: We performed a retrospective study evaluating the effect on survival of different sites of microscopic residual disease at the bronchial resection margin after surgical intervention for non-small cell lung cancer.

Methods: Survival of patients with different sites of residual disease was compared with survival of patients with curative resections, taking the pathologic TNM stage of the tumor into consideration.

Results: There was a trend for patients with stage I and II non-small cell lung cancer with residual disease limited to the epithelium and with peribronchial invasion to behave like patients with complete resections (61% and 41% five-year survival for stage I and II disease, respectively).

Lymph node ratio as an alternative to pN staging in node-positive breast cancer.

Purpose: In the current pTNM classification system, nodal status of breast cancer is based on the number of involved lymph nodes and does not account for the total number of lymph nodes removed. In this study, we assessed the prognostic value of the lymph node ratio (LNR; ie, ratio of positive over excised lymph nodes) as compared with pN staging and determined its optimal cutoff points.

Patients And Methods: From the Geneva Cancer Registry, we identified all women diagnosed with node-positive breast cancer between 1980 and 2004 (n = 1,829).

Increased risk of colon cancer after external radiation therapy for prostate cancer.

Radiotherapy can induce second cancers. Controversies still exist regarding the risk of second malignancies after irradiation for prostate cancer. We evaluated the risk of developing colon and rectum cancers after prostate cancer in irradiated and nonirradiated patients.

Recent trends in prostate cancer mortality show a continuous decrease in several countries.

Prostate specific antigen (PSA) screening was introduced to detect prostate cancer at an early stage and to reduce prostate cancer-specific mortality. Until results from clinical trials are available, the efficacy of PSA screening in reducing prostate cancer mortality can be estimated by surveillance of prostate cancer mortality trends. Our study analyzes recent trends in prostate cancer mortality in 38 countries.

Increased risk of second cancer among patients with ovarian borderline tumors.

Objectives: Several studies have demonstrated a higher risk of colorectal and breast cancers subsequent to invasive ovarian cancer. Such risk has not been investigated for ovarian borderline tumors. We aim to evaluate the risk of subsequent cancer occurrence among patients with borderline ovarian tumors in a population-based setting.

Family history of breast or ovarian cancer modifies the risk of secondary leukemia after breast cancer: results from a population-based study.

We evaluated the impact of a family history of breast/ovarian cancer on the risk of secondary leukemia following breast cancer. At the Geneva cancer registry, we identified 4,397 patients diagnosed with invasive breast cancer between 1990 and 2004. Patients were followed up for leukemia until the end of 2005.

Short- and long-term mortality with localized prostate cancer.

Background: No clear guidelines exist for managing localized prostate cancer because clinical studies have not yet established which treatment provides the best long-term outcome. We assessed the effect of treatment on prostate cancer-specific mortality considering the determinants of treatment and prognosis.

Methods: The population-based cohort included all 844 patients having a diagnosis of localized prostate cancer between January 1, 1989, and December 31, 1998, in Geneva, Switzerland.

Survival after bilateral breast cancer: results from a population-based study.

Background: Controversy exists on the impact of bilaterality of breast cancer on survival. We used population-based data to compare survival of women with unilateral versus bilateral breast cancer.

Patients And Methods: At the Geneva cancer registry, we identified all 7,912 women diagnosed with invasive breast cancer between 1970 and 2002.

Tumor location of the lower-inner quadrant is associated with an impaired survival for women with early-stage breast cancer.

Background: There is growing evidence that tumors of the inner quadrants (especially the lower-inner quadrant) metastasize more often to the internal mammary chain (IMC). As these metastases are not investigated, patients with lower-inner quadrant tumors have an increased risk of being under-staged and under-treated and may therefore have a higher risk of death from breast cancer.

Methods: We identified all 1522 women operated for stage I breast cancer between 1984 and 2002 recorded at the population-based Geneva Cancer Registry.

Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis.

Purpose: Surgery of the primary tumor usually is not advised for patients with metastatic breast cancer at diagnosis because the disease is considered incurable. In this population-based study, we evaluate the impact of local surgery on survival of patients with metastatic breast cancer at diagnosis.

Methods: We included all 300 metastatic breast cancer patients recorded at the Geneva Cancer Registry between 1977 and 1996.

Social class is an important and independent prognostic factor of breast cancer mortality.

Reasons of the important impact of socioeconomic status on breast cancer prognosis are far from established. This study aims to evaluate and explain the social disparities in breast cancer survival in the Swiss canton of Geneva, where healthcare costs and life expectancy are among the highest in the world. This population-based study included all 3,920 female residents of Geneva, who were diagnosed with invasive breast cancer before the age of 70 years between 1980 and 2000.

Remarkable change in age-specific breast cancer incidence in the Swiss canton of Geneva and its possible relation with the use of hormone replacement therapy.

Background: This article aims to explain the reasons for the remarkable change in age of breast cancer occurrence in the Swiss canton of Geneva.

Methods: We used population-based data from the Geneva cancer registry, which collects information on method of detection, stage and tumour characteristics since 1975. For patients diagnosed between 1997-2003, we obtained additional information on use of hormone replacement therapy from a large prospective study on breast cancer.

Patients' refusal of surgery strongly impairs breast cancer survival.

Objective: To compare patient and tumor characteristics and survival between women who refused and women who accepted surgery for breast cancer.

Summary Background Data: Surgery represents the central component of curative breast cancer treatment, but some women decide not to undergo surgery. Recent studies on the prognosis of non operated breast cancer are nonexistent.

Survival of young and older breast cancer patients in Geneva from 1990 to 2001.

The effect of age on breast cancer survival is still a matter of controversy. Breast cancer in young women is thought to be more aggressive and to have worse prognosis but results from clinical research have been neither consistent nor definitive. In this study, we have assessed the impact of young age at diagnosis on tumor characteristics, treatment and survival of breast cancer.

Breast-conserving surgery has equivalent effect as mastectomy on stage I breast cancer prognosis only when followed by radiotherapy.

Background And Purpose: Early-stage breast cancer is increasing and consequently the use of breast-conserving surgery (BCS). We examined the effect of mastectomy and BCS on overall and breast cancer survival in routine health care in Geneva, Switzerland.

Patients And Methods: We included all stage I breast cancers treated by surgery (n=1046) recorded at the Geneva Cancer Registry between 1988 and 1999.