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HERDIN Record #: PCHRDPC040684 Submitted: 16 May 2007 Modified: 01 March 2018

Population-based survey of treatment practices for early breast cancer in the cities of Manila, Quezon, Pasay and Caloocan during incident years 1991, 1994 and 1997.

Adriano V. Laudico,
Cynthia A. Mapua,
Paula Pisani

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OBJECTIVE: To describe some population-based clinical practices on early breast cancer in Metro Manila.
METHODS: New breast cancer cases registered in 1991, 1994, and 1997 in the cities of Manila, Quezon, Pasay and Caloocan were obtained from the database of the Philippine Cancer Society-Manila Cancer Registry. A sample of 992 cases were randomly selected, of which 738 were included. An abstract form was prepared to collect information on diagnostic tests, TNM stage and treatments received separated into surgery, radiotherapy (RT), chemotherapy (CT) and hormone therapy (HT). After reviewing hospital records, the treating physicians were contacted to obtain additional information.
RESULTS: The mean age was 50.3 years, 52.4 percent were less than 50 years. Stage distribution in percent were: I 10.4, IIA 31.2, IIB 28.9, IIIA 15.0, IIIB 12.2. T2 tumors (2cm to 5cm) comprised 48.4 and 49.0 percent had positive axillary nodes. Aside from chest radiographs, only 4 percent had additional preoperative imaging tests. Modified radical mastectomy was done in 96.8 percent of cases, and 97.5 percent of axillary dissections were total axillary dissections. Only 17.9 percent had adjuvant radiotherapy. Adjuvant chemotherapy (CT) was given to 47.0 percent. Among 373 cases with negative axillary nodes, 41.8 percent were given CT. Among 350 women with age 350 years with age 50 years 38 percent received CT. Adjuvant CT use increased over time. Adjuvant hormone therapy (HT) was given to 51.2 percent. Tamoxifen alone was given to 50.5 percent, and only 7 cases underwent oophorectomy. Over time, the use of HT increased among node-negative cases but not in node-positive cases. HT use increased in both age-groups over time. Combined CT and HT were given to 38.0 percent, and this practice increased over time. Prescribing physicians were mainly surgeons (68.9 percent) and medical oncologists (29.2 percent).
CONCLUSIONS: Women with early breast cancer in these four cities did not receive surgical treatment as early as those in some developed countries. A major focus should be on strategies to have earlier surgical treatment for women with detected breast lesions. Compliance to local treatment guidelines on adjuvant treatment needs improvement, particularly on high survival benefit modalities that are cost-effective, accessible and sustainable in developing countries.

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Surgical Specialties
Publication Date
October-December 2004
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No.6 Fulltext pdf (Request Document)
1. Laudico, A. V., Esteban, D. B., Reyes, L. M.. Philippines, Manila. . In: Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (editors) Cancer Incidence in Five Continents Lyon, France: International Agency for Research on Cancer (WHO) Scientific Publications No. 155, 2002. 286-287. (Vol. VIII)
2. "Early Breast Cancer Trialists" N Engl J Med 319, 1681-1692, 1988. Retrieved from:
3. "Early Breast Cancer Trialists" Lancet 339, 1-15, 71-8, 1992. Retrieved from:
4. "Early Breast Cancer Trialists" N Engl J Med 333, 1444-1445, 1995. Retrieved from:
5. "Early Breast Cancer Trialists" Lancet 348(9036): 1189-1196, . Retrieved from:
6. "Early Breast Cancer Trialists" Lancet 352(9132): 930-942, 1998. Retrieved from:
7. "Early Breast Cancer Trialists" Lancet 351(9114): 1451-1467, 1998. Retrieved from:
8. Nagel, G. , Rohrig, B. , Wedding, , Hoye, H. , Wedding, U. , Katenkamp, D. . "A population-based study on variations in the use of adjuvant systemic therapy on postmenopausal women with early stage of breast cancer" J Cancer Res Clin Oncol 129(3): 183-191, 2003. Retrieved from:
9. Engel, J. , Nagel, G. , Breuer, E. , et al., . "Primary breast cancer therapy in six regions in Germany" Eur J Cancer 38(4): 578-585, 2002. Retrieved from:
10. Laudico, A. V.. "Oncology Rounds 1 - Breast Cancer. Cancer Bulletin" Philippine College of Surgeons 1(1): 3-8, 1989
11. Breast Cancer. In Laudico AV, de la Peña AS, Cabaluna ND de los Reyes RH (editors) Cancer Treatment Guidelines Manila: Philippine College of Surgeons Scientific Publication No. 6, 1994. 18-23. (2nd Editio)
12. Matsuda, M. L., Laudico, A. V., Yosuico, V.E. D., et al., . "Evidence-based clinical practice guidelines inthe diagnosis and management of breast cancer. Part 1. Early breast cancer" Philip J Surg Spec 56(1): 7-30, 2001
13. Matsuda, M. L., Laudico, A. V., Cabaluna, N. D., et al., . "Evidence-based clinical practice guidelines on the diagnosis and management of breast cancer. Part II. Locally advanced breast cancer, locally recurrent breast cancer and metastatic breast cancer" Philip J Surg Spec 56(4): 135-164, 2001
14. Mapua, C. A., Redaniel, M.T. M., Laudico, A. V., Reyes, L. M.. Population-based cancer survival in the cities of MAnila, Quezon, Pasay and Caloocan (1987 Cohort). Manila: Philippine Cancer Society, 2004.
15. Breast. In Fleming ID, Cooper JS, Henson DE, et al. (editors) AJCC Cancer Staging Manual Philadelphia - New York: Lippincott - Raven, 1997. 171-180. (Fifth Edit)
16. Ahn, S. H.. "Clinical characteristics of breast cancer patients in Korea in 2000" Arch Surg 139(1): 27-30, 2004. Retrieved from:
17. Pisani, P. , Parkin, D. M., Ngelangel, , et al., . Screening for breast cancer by clinical examination: a randomised trial in the Philippines. Lyon, France: International Agency for Research on Cancer, 2002.
18. Jatoi, I. , Milller, A. B.. "Why is breast-cancer mortality declining?" Lancet Oncol 4(4): 251-254, 2003. Retrieved from:
19. Carison, R. W., Anderson, B. O., Chopra, R. , et al., . "Treatment of breast cancer in countries with limited resources" Breast J 9(Suppl 2): S67-74, 2003. Retrieved from:
20. Laudico, A. V., Matsuda, M. L., Roxas, M.F. T.. "Results of a survey on some practices regarding breast cancer management by surgeons in the Philippines" Philipp J Surg Spec 56(1): 31-45, 2001
21. "Scottish Cancer Trials Breast Group and ICRF Breast Unit, Guys" Lancet 341(8856): 1293-1298, 1993. Retrieved from:
22. Jonat, W. , Kaufmann, W. , Sauerbrei, R. , et al., . "Goserelin versus cyclophosphamide, methotrexate and fluorouracil as adjuvant therapy in premenopausal patients with node-positve breast cancer; The Zoladex Early Breast Cancer Research Association Study" J Clin Oncol 20(24): 4628-4635, 2002. Retrieved from:
23. Jakesz, R. , Hausmaninger, H. , Kubista, E. , et al., . "Randomised adjuvant trial of tamoxifen and goserelin versus cyclophosphamide, methotrexate and fluorouracil: Evidence for the superiority of treatment with endocrine blockade in premenopausal patients with hormone responsive breast cancer - Australian Bre" J Clin Oncol 20(24): 4621-4627, 2002. Retrieved from:
24. Thomson, C. S., Twelves, C. J., Maillon, E. A., Leake, R. E.. "Adjuvant ovarian ablation vs CMF chemotherapy in premenopausal breast cancer patients: trial update and impact of immunohistochemical assessment of ER status" Breast 11(5): 419-429, 2002. Retrieved from:
25. Pritchard, K. I.. "Adjuvant therapy for premenopausal women with breast cancer: is it time for another paradigm shift?" J Clin Oncol 20(24): 4611-4614, 2002. Retrieved from:
26. Soreide, J. A., Varhaug, J. E., Fjosne, H. E., et al., . "Adjuvant endocrine treatment (goserelin vs tamoxifen) in premenopausal patients with operable node positive stage II breast cancer. a prospective randomized national multicenter study" Eur J Surg Oncol 28(5): 505-510, 2002. Retrieved from:
27. Kaufmann, M. , Jonat, With , Blamey, R. , et al., . "Survival analysis from the ZEBRA study: goserelin (Zoladex) versus CMF in premenopausal women with node-positive breast cancer" Eur J Cancer 39(12): 1711-1717, 2003. Retrieved from:
28. Pritchard, K. I.. "The best use of adjuvant endocrine treatments" Breast 12(6): 497-508, 2003. Retrieved from:
29. Aebi, S. , Castiglione-Gertsch, M. . "Adjuvant endocrine therapy for the very young patients" Breast 12(6): 509-515, 2003. Retrieved from:
30. Rutqvist, L. E.. "Adjuvant endocrine therapy" Best Pract Res Clin Endocrinol Metab 18(1): 81-95, 2004. Retrieved from:
31. Love, R. R., Ba Duc, N. , Allred, D. C., et al., . "Oophorectomy and tamoxifen adjuvant therapy in premenopausal Vietnamese and Chinese women with operable breast cancer" J Clin Oncol 20(10): 2539-2566, 2002. Retrieved from:
32. Love, R. R., Duc, N. B., Dinh, N. V., et al., . "Mastectomy and ophorectomy by menstrual cycle phase in women with operable breast cancer" J Natl Cancer Inst 94(9): 662-669, 2002. Retrieved from:
33. Sainsbury, R. . "Ovarian ablation as a treatment for breast cancer" Surg Oncol 12(4): 241-250, 2003. Retrieved from:
34. Pico, C. , Martin, M. , Jara, C. , Barnadas, , et al., . "Epirubicincyclophosphamide adjuvant chemotherapy plus tamoxifen administered concurrently versus sequentially: randomized phase III trial in postmenopausal node-positive breast cancer patients. A GEICAM 9401 study" Ann Oncol 15(1): 79-87, 2004. Retrieved from:
35. Fountzilas, G. , Stathopoulos, G. , Kouvatseas, G. , Polychronis, A. , et al., . "Adjuvant cytotoxic and endocrine therapy in pre- and postmenopausal patients with breast cancer and one to nine infiltrated nodes: five year results of the Hellenic Cooperative Oncology Group randomized HE 10/92 study" Am J Clin Oncol 27(1): 57-67, 2004. Retrieved from:
36. Crivellari, D. , Price, K. , Gelber, R. D., Castiglione-Gertsch, M. , et al., . "Adjuvant endocrine therapy compared with no systemic therapy for elderly women with early breast cancer: 21-year results of International Breast Cancer Study Group Trial IV" J Clin Oncol 21(24): 4517-4523, 2004. Retrieved from:
37. Castiglione-Gertsch, M. , O Neill, A. , Price, K. N., Goldhirsch, A. , et al., . "Adjuvant chemotherapy followed by goserelin versus either modality alone for premenopausal lymph node-negative breast cancer: a randomized trial" J Natl Cancer Inst 95(24): 1833-1846, 2003. Retrieved from:
38. "International Breast Cancer Study Group. Endocrine responsiveness and tailoring therapy for postmenopausal lymph node-negative breast cancer: a randomized trial" J Natl Cancer Inst 94(14): 1054-1065, 2002
39. Hata, Y. , Takahashi, H. , Todo, S. , Okazaki, M. , et al., . "Ten year results of a randomized trial on adjuvant chemoendocrine therapy with tamoxifen for stage II breast cancer" Breast Cancer 10(2): 134-139, 2003. Retrieved from:
40. Arriagada, R. , Spielmann, M. , Koscieniny, S. . "Patterns of failure in a randomized trial of adjuvant chemotherapy in postmenopausal patients with early breast cancer treated with Tamoxifen" Ann Oncol 13(9): 1378-1386, 2002. Retrieved from:



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