Norwegian Breast Cancer Registry
Article
|Last update
4199 women were diagnosed with breast cancer for the first time in 2024. The volume of surgeries at the various hospitals performing breast cancer surgery in Norway still varies significantly.
Summary from the annual report 2024
Radiology
Radiology examinations were reported for 78,4 % of breast cancer patients and considered a moderate goal achievement. There has been an ongoing effort to increase reporting. For cases detected by BreastScreen Norway, all except one breast center achieved the target level of 80 %. Use of MRI for women who received neoadjuvant treatment has increased in recent years and is now 96,4 %, which is above EUSOMA’s quality target of ≥ 90 %. Use of MRI for women not receiving neoadjuvant treatment is 37,2 %, considered a high goal achievement. However, there are variations across breast centers.
Pathology
As seen in previous years, grading of tumors still varies between hospitals. Grade is used to determine treatment, so quality assurance of this variable is important. Previously, we observed large variation in median Ki67 between pathology laboratories, but many pathology departments now have a median Ki67 at, or close to, the national level. The waiting time for pathology results after surgery is currently too long, leading to a delay in the start of oncological treatment.
Surgery
Clinical reporting was 93,0 % complete for primary diagnosis, 93,2 % complete for primary surgery, and 89,9 % for the first post-operative check-up. These are all considered to be high levels of goal achievement. For patients with invasive tumors ≤ 30 mm, 90,0 % received breast-conserving surgery. The EUSOMAS target of ≥ 90 % was achieved. There was minor variation in use of breast-conserving surgery between the hospitals, and some hospitals could potentially perform more breastconserving surgery. For patients diagnosed with ductal carcinoma in situ (DCIS), with a tumor size ≤ 20 mm, 92,6 % received breastconserving surgery during 2022–2024. This was considered a high degree of goal achievement.
EUSOMA recommends primary reconstruction for ≥ 60 % of patients < 70 years with DCIS and invasive disease who had a mastectomy without radiotherapy. In 2024, 56,3 % of these patients received a primary reconstruction, which was a moderate goal achievement.
There was reasonably large variation in annual surgical volume between hospitals that conduct breast cancer surgery in Norway. With the increasing complexity of treatment, reducing the number of hospitals diagnosing and treating breast cancer should be considered.
Oncology
Radiotherapy was given to 97,2 % of patients after breast conserving surgery, which is considered a high goal achievement. Neoadjuvant treatment was given to 85,6 % of patients < 75 years with HER2-positive or triple-negative clinical stage II-III breast cancer, which is considered a moderate target achievement. EUSOMA’s quality target is ≥ 90 %. Use of neoadjuvant treatment varies between hospitals and should be monitored in the years ahead.
Neoadjuvant or surgical treatment was started within 42 days of diagnosis for 91,9 % of patients with stage I-III HER2-positive or triple-negative breast cancer, which is a high goal achievement. EUSOMA’s target is ≥ 90 %, with moderate target of ≥ 80 %. For patients with triple-negative breast cancer, adjuvant chemotherapy should start within 30 days after surgery, and the professional breast cancer council will follow this recommendation in subsequent reports.
Patient Reported Outcome Measures (PROM) and Patient Reported Experience Measures (PREM)
This year’s report presents results from the PROM 3-year survey and PREM 14-month and 3-year surveys. Results should be interpreted with care due to a limited number of responses. Among those invited to the 3-year survery, 48,4% of breast cancer patients and 55,5 % of controls responded.
Patient-reported outcomes three years after diagnosis show, among other things, that women with breast cancer report that breast-conserving surgery seems to give less negative body image compared to mastectomy with or without primary reconstruction and that women with breast cancer report more fatigue compared to women without breast cancer of the same age. Norwegian breast cancer patients are largely satisfied with their treatment and follow-up by the hospitals.
