Changing pattern in the clinical presentation of breast cancer in the absence of a screening program over a period of thirty-three years in Iran

- During the study period the proportion of advanced stages of disease significantly decreased.
- In the absence of a screening program the proportion of early stages increased significantly.
- The most significant changes occurred among rural population.
- The percentage of stage IV disease declined by half from the first to the last period of the study.
- The percentages of in situ and T1 tumors did not change remarkably during the study period.

ObjectiveTo survey the proportion of stages at the presentation of the disease without a screening program, among a population of breast cancer patients that is as a representative sample of the country in a distinct period.Materials and methodsThe population of the current study is found among the female breast cancer patients who were referred to oncology centers in northeastern Iran over a thirty-three-year period from 1980 to 2012.ResultsFour thousand patients were divided into three time periods consisting of 521 cases from 1980 to 1990, 1178 cases from 1991 to 2001, and 2302 cases from 2002 to 2012. While there was no difference in the proportions of T1 and T3 tumors, T2 tumors showed an increase (P = 0.001) and T4 tumors a decrease (P = 0.000) during these periods. There was no change in the proportion of stage I, however the proportion of stage II had risen (P = 0.000), while that of stage III (P = 0.002), and stage IV (P = 0.000) had fallen. The study's urban and rural populations experienced a similar trend in this respect, with the exception that the rural population exhibited more striking changes during the study's recent years.ConclusionAfter a thirty-three-year follow up on breast cancer in northeastern Iran, it is obvious that this disease is now presented in its earlier stages even in the absence of a screening program. In spite of this, the proportion of T1 disease and those tumors are discovered by a screening program has not significantly changed.