Breast cancer in Malta : a comparative study between the year 2000 and 2010

Abstract

Introduction: During the last decade, Malta experienced the introduction of a number of programmes and initiatives aiming to raise risk and cancer awareness on breast cancer. The aim of this retrospective study was to assess whether the rise in breast cancer awareness influenced the presentation pattern of breast cancer in Malta. Method: The patients’ records operated for breast cancer in the year 2000 and 2010 were reviewed after sourcing the list from the Pathology Department at Mater Dei Hospital. For each case demographics, laterality, surgical procedure, histology of tumour, largest histological tumour dimension, differentiation and nodal status were collected. Results: 456 patients were studied; 171 for the year 2000 and 285 for the year 2010. Median age was 64 years (range 23-91 years) in 2000 and 59 years (range 29-96 years) in 2010. Lumpectomy or wide local excision were carried out in 41.0% of patients in 2000 and 64.7% in 2010. Mastectomy was done in 49.7% of patients in 2000 and 27.1% in 2010. Invasive ductal carcinoma of the unspecified type was the most common histological tumour in both years (68.8% in 2000, 74.7% in 2010). Peak incidence for the histological tumour dimension shifted from pT2 in 2000 to pT1c in 2010. Mean tumour size of the invasive type decreased from 28.2mm in the year 2000, to 22.9mm in the year 2010 (p value = 0.007). Histological regional lymph node metastases decreased from 52.2% in 2000 to 45.0% in 2010. Conclusion: Our study shows a trend of decrease in tumour size, less axillary node metastases and an increase in breast conservation surgery. Current initiatives and programmes appear to be effective at increasing breast cancer awareness.