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Annals of Surgical Oncology

, Volume 20, Issue 9, pp 2822–2827

First Online: 11 June 2013Received: 08 November 2012DOI: 10.1245-s10434-013-3025-3

Cite this article as: Grau, J.J., Zanon, G., Caso, C. et al. Ann Surg Oncol 2013 20: 2822. doi:10.1245-s10434-013-3025-3


BackgroundMany women covered by the Spanish public health system also have an extra private insurance policy for gynecological examinations and routine annual mammography. We retrospectively analyzed the long-term survival rates in these patients when diagnosed with breast cancer.

MethodsWe analyzed the survival and prognostic factors in patients diagnosed with breast cancer who were referred to a medical oncology unit for multidisciplinary treatment covered by private health insurance.

ResultsBetween 1994 and 2009, a total of 434 patients with breast tumor were analyzed: 33 in situ and 401 infiltrating. Among the infiltrating carcinomas, 38 were stage IV and 363 were stage I, II, or III. With a median follow-up of 62 months, the 5-year global survival rate was 91 %: 97 % for stage I, 94 % for stage II, and 77 % for stage III tumors. In the patients diagnosed by routine mammography, the 5-year survival rate was 96 %, compared with 86 % in those consulting their gynecologist after breast self-examination or for other symptoms p = 0.0159. Seventy-four percent were treated conservatively and experienced better survival than the 26 % who underwent mastectomy p = 0.0024. Patients with disease with positive hormone receptors had a better survival rate p = 0.0264; hormone receptor status was the only independent prognostic factor in the Cox multivariate analysis. Postmenopausal patients who received adjuvant tamoxifen plus exemestane had a better prognosis than those who received tamoxifen alone p = 0.0203.

ConclusionsLong-term survival rate was high in breast cancer patients with extra private insurance coverage. This is probably because disease was diagnosed at an early stage.

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Autor: Juan J. Grau - Gabriel Zanon - Carlos Caso - Xavier Gonzalez - Araceli Rodriguez - Miguel Caballero - Albert Biete


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