Niels Kroman

Copenhagen University Hospital, København, Capital Region, Denmark

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Publications (99)349.48 Total impact

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    ABSTRACT: The main purpose of this nationwide follow-up study was to examine the development of self-reported lymphedema in the population of women with early-stage breast cancer in Denmark. In 2008 and 2012 two identical questionnaires were sent to the women aged 18-70 years treated for unilateral primary breast cancer in 2005 and 2006. 2293 women (87%) reported on lymphedema in 2008 and 2012. Overall 37% reported lymphedema in 2008 while 31% reported lymphedema in 2012 and severity of symptoms decreased. 50% of women treated with SLNB and reporting lymphedema in 2008 did not report symptoms by 2012 in contrast to 30% treated with ALND. However, 19% of women treated with ALND and not reporting lymphedema in 2008 had developed lymphedema by 2012. In conclusion lymphedema remains a frequent problem, years after treatment for breast cancer, though, number of women reporting lymphedema and overall severity of symptoms decreased.
    Breast (Edinburgh, Scotland) 04/2014; · 2.09 Impact Factor
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    ABSTRACT: Background. During the last decades the diagnosis, treatment, and prognosis of breast cancer have changed and improved in Denmark. The first mammography screening programme started in 1991. However, for many years only about 20% of Danish women aged 50-69 were offered screening. The national roll-out of screening took place in 2008-2010. Material and methods. Based on published Danish data, this overview describes the status of diagnosis and treatment, and the screening programme. For further evaluating the potential overdiagnosis and overtreatment, additional Danish Breast Cancer Cooperative Group (DBCG) data are included. Results and conclusion. Using incidence-based mortality method, reduction in breast cancer mortality was estimated to be 25% in the target group of women after 10 years of screening in Copenhagen; an outcome comparable to that of randomised controlled trials. A recent Danish study has indicated overdiagnosis to be around 4%. Others have estimated overdiagnosis to be 33%. National DBCG data showed that the rude breast cancer incidence increased during the period 1990-2011 from 126 to 206 per 100 000. The incidence was almost constant for women younger than 50 years. In regions not offering screening, the incidence increased with 3% per year for women aged 50-69 years with similar trends for small and large tumours. After introduction of screening the increase in the age group 50-69 years was confined to small tumours ≤ 20 mm, and most pronounced for node negative patients. From the 1990s, the use of breast conserving surgery has increased from around 25% to 69% in 2010. Screening has not increased the number of mastectomies. Breast cancer treatment in Denmark is evidence based and in agreement with international recommendations. After the introduction of mammography screening the absolute number of patients with a more advanced stage at diagnosis and the absolute number of patients undergoing mastectomy have decreased.
    Acta oncologica (Stockholm, Sweden) 02/2014; · 2.27 Impact Factor
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    ABSTRACT: The main purpose of this nationwide follow-up study was to examine the development of self-reported lymphedema in the population of women with early-stage breast cancer in Denmark. In 2008 and 2012 two identical questionnaires were sent to the women aged 18–70 years treated for unilateral primary breast cancer in 2005 and 2006. 2293 women (87%) reported on lymphedema in 2008 and 2012. Overall 37% reported lymphedema in 2008 while 31% reported lymphedema in 2012 and severity of symptoms decreased. 50% of women treated with SLNB and reporting lymphedema in 2008 did not report symptoms by 2012 in contrast to 30% treated with ALND. However, 19% of women treated with ALND and not reporting lymphedema in 2008 had developed lymphedema by 2012. In conclusion lymphedema remains a frequent problem, years after treatment for breast cancer, though, number of women reporting lymphedema and overall severity of symptoms decreased.
    The Breast. 01/2014;
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    ABSTRACT: Background We cross-validated three existing models for the prediction of non-sentinel node metastases in patients with micrometastases or isolated tumor cells (ITC) in the sentinel node, developed in Danish and Finnish cohorts of breast cancer patients, to find the best model to identify patients who might benefit from further axillary treatment. Material and method Based on 484 Finnish breast cancer patients with micrometastases or ITC in sentinel node a model has been developed for the prediction of non-sentinel node metastases. Likewise, two separate models have been developed in 1577 Danish patients with micrometastases and 304 Danish patients with ITC, respectively. The models were cross-validated in the opposite cohort. Results The Danish model for micrometatases was accurate when tested in the Finnish cohort, with a slight change in AUC from 0.64 to 0.63. The AUC of the Finnish model decreased from 0.68 to 0.58 when tested in the Danish cohort, and the AUC of the Danish model for ITC decreased from 0.73 to 0.52, when tested in the Finnish cohort. The Danish micrometastatic model identified 14-22 % of the patients as high-risk patients with over 30 % risk of non-sentinel node metastases while less than 1 % was identified by the Finish model. In contrast, the Finish model predicted a much larger proportion of patients being in the low-risk group with less than 10% risk of non-sentinel node metastases. Conclusion The Danish model for micrometastases worked well in predicting high risk of non-sentinel node metastases and was accurate under external validation.
    European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 01/2014; · 2.56 Impact Factor
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    ABSTRACT: Few studies have examined the prevalence of persistent pain after breast reconstruction with an implant after tissue expansion in comparison to mastectomy without breast reconstruction. Our primary objective was to evaluate the prevalence of persistent pain after breast reconstruction with a subpectoral implant after tissue expansion in a population-based study. Secondary objectives were to evaluate sensory disturbances, lymphoedema and functional impairment. This was a nationwide cross-sectional questionnaire study of breast cancer patients aged 18-69 years who were treated with or without reconstruction after mastectomy for primary breast cancer in Denmark between 1 January 2005 and 31 December 2006. The response rate was 84% for mastectomy without reconstruction and 83% for patients treated with breast reconstruction. A total of 129 patients treated with mastectomy and breast reconstruction with a subpectoral implant were compared with 1131 patients treated with mastectomy without reconstruction. Prevalence of persistent pain for patients treated with mastectomy followed by reconstruction with an implant was 40% compared to 48% of patients treated only with mastectomy. We found no increased risk of persistent pain in patients having a reconstruction with an implant compared with mastectomy without reconstruction (odds ratio (OR) 0.82, 95% confidence interval (CI) 0.55-1.22, P = 0.33) when adjusting for age, axillary procedure, radiotherapy and chemotherapy. We observed no difference in the prevalence of pain between patients treated with immediate or delayed breast reconstruction (P = 0.116). Breast reconstruction with a subpectoral implant after tissue expansion does not confer increased prevalence of persistent pain.
    Journal of Plastic Reconstructive & Aesthetic Surgery 08/2013; · 1.44 Impact Factor
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    ABSTRACT: Background. Benefit from axillary lymph node dissection in sentinel node positive breast cancer patients is under debate. Based on data from 1820 Danish breast cancer patients operated in 2002-2008, we have developed two models to predict high risk of non-sentinel node metastases when micrometastases or isolated tumor cells are found in sentinel node. The aim of this study was to validate these models in an independent Danish dataset. Material and methods. We included 720 breast cancer patients with micrometastases and 180 with isolated tumor cells in sentinel node operated in 2009-2010 from the Danish Breast Cancer Cooperative Group database. Accuracy of the models was tested in this cohort by calculating area under the receiver operating characteristic curve (AUC) as well as sensitivity and specificity. Results. AUC for the model for patients with micrometastases was comparable to AUC in the original cohort: 0.63 and 0.64, respectively. The sensitivity and specificity for predicting risk of non-sentinel node metastases over 30% was 0.36 and 0.81, respectively, in the validation cohort. AUC for the model for patients with isolated tumor cells decreased from 0.73 in the original cohort to 0.60 in the validation cohort. When dividing patients with isolated tumor cells into high and low risk of non-sentinel node metastases according to number of risk factors present, 37% in the high-risk group had non-sentinel node metastases. Specificity and sensitivity was 0.48 and 0.88, respectively, in the validation cohort when using this cut-point. Conclusion. In this independent dataset, the model for patients with micrometastases was robust with accuracy similar to the original cohort, while the model for patients with isolated tumor cells was less accurate. The models may be used to identify patients where axillary lymph node dissection should still be considered.
    Acta oncologica (Stockholm, Sweden) 06/2013; · 2.27 Impact Factor
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    ABSTRACT: Lymphedema and impairment of function are well-established sequelae to breast cancer treatment and affect an increasing number of women due to continually improved survival. The aim of the present nationwide questionnaire study was to examine the impact of breast cancer treatment on perceived swelling/sensation of heaviness (lymphedema) and on function, reporting prevalence in 12 subgroups of modern treatment and offering estimates for treatment-related associated factors.3253 Women (87%) returned the study questionnaire. Depending on treatment group prevalence of perceived swelling/heaviness varied from 13 to 65%. Associated factors were young age, axillary lymph node dissection (ALND) and radiotherapy but not type of breast surgery or use of chemotherapy. Depending on treatment group 11–44% had to give up activities. Giving up activities was associated with pain and swelling/heaviness, younger age, ALND, chemotherapy, time elapsed since surgery, and surgery on the dominant side. Radiotherapy and type of breast surgery were of no importance.
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    ABSTRACT: INTRODUCTION: Breast cancer is common among Danish women with more than 4,100 new cases annually. In 2008 the concept of fast-track surgery was introduced at the Department of Breast Surgery at Rigshospitalet, Copenhagen. The aim of this study is to describe the new clinical pathway for breast cancer patients after implementation of a fast-track surgery programme. MATERIAL AND METHODS: A clinical pathway of all involved disciplines was developed including anaesthetic, analgesics, nausea and vomiting, drain and wound management, discharge assessment and psychosocial support. RESULTS: The overall mean length of stay (LOS) decreased from 3.6 days before introduction of fast-track surgery to 1.2 days after its implementation. The largest decrease was observed among patients undergoing mastectomy, where LOS was reduced from 5.0 to 1.6 days. The number of beds at the department was reduced by about 30% and a nurse-led clinic was established which enabled nurses to take charge of wound management, seromas, temporary breast prostheses and psychosocial and rehabilitation aspects in the outpatient clinic. Additionally, the previously available telephone counselling service was intensified to provide immediate advice and support. CONCLUSION: The results confirm that a short stay can be successfully carried out for breast cancer patients. Implementing the fast-track programme involved the introduction of a clear clinical pathway for the patients and more effective daily routines. Patients felt safe and confident after early discharge. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
    Danish medical journal. 05/2013; 60(5):A4615.
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    ABSTRACT: Long-term breast cancer trends in incidence in the United States (US) show rising ER positive rates and falling ER negative rates. We hypothesized that these divergent trends reflect etiologic heterogeneity and that comparable trends should be observed in other countries with similar risk factor profiles. We, therefore, analyzed invasive female breast cancers in Denmark, a country with similar risk factors as the US. We summarized the overall trend in age-standardized rates with the estimated annual percentage change (EAPC) statistic (1993-2010) and used age-period-cohort models to estimate age-specific EAPCs, cohort rate ratios (CRRs), and projections for future time periods (2011-2018). In Denmark, the overall rate of ER positive cancers rose between 1993 and 2010 by 3·0%/year (95% CI: 2·8 to 3·3%/yr) while the overall rate of ER negative cancers fell by 2·1%/year (95% CI: -2·5 to -1·6%/yr). The ER positive rate increased fastest among postmenopausal women and the ER negative rate decreased fastest among premenopausal women, reflecting that cohorts born after 1944 were at relatively higher risk of ER positive tumors and lower risk of ER negative tumors. If current trends continue, ER positive cancers will increase at least 13% by 2018 in Denmark, ER negative cancers will fall 15% by 2018, and breast cancer overall will increase at least 7% by 2018. Divergent ER-specific trends are consistent with distinct etiologic pathways. If trends in known risk factors are responsible, the Danish and US experience may foreshadow a common pattern worldwide. © 2013 Wiley Periodicals, Inc.
    International Journal of Cancer 04/2013; · 6.20 Impact Factor
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    ABSTRACT: INTRODUCTION: Digoxin use is associated with increased incidence of breast and uterus cancers. We postulated that digoxin use might affect tumor characteristics and increase relapse risk in women with breast cancer. METHODS: Incident breast cancer cases in Danish women (N= 49,312; 1995-2008) were identified. Analyses were conducted in women 20-74 years old. Relapse hazard ratios (HR) were compared in women using and not-using digoxin, adjusting for age, calendar period, protocol, tumor size, nodal involvement, histology grade, estrogen-receptor (ER) status, and anti-estrogen therapy in Cox regression models. RESULTS: 45 relapses occurred in women already using digoxin at breast cancer diagnosis (1,487 person-years). 24 relapses occurred in women later starting digoxin (384 person-years). At diagnosis, tumors in digoxin users were more likely ER+ (85.4% vs. 78.6%; p=0.002) and have Grade 1 ductal histology, compared to non-users (37.2% vs. 25.7%; p=0.004). Overall relapse HR in digoxin users was 1.13 (95% confidence interval: 0.88-1.46) compared to non-users. Relapse risk in digoxin users was significantly increased in the first year (2.19; 1.26-3.78) but not thereafter (0.99; 0.74-1.32) (p=0.02 for difference in HRs). First-year relapse hazard was high in digoxin-using women with ER+ tumors (2.51; 1.39-4.55) but not ER- tumors (0.72; 0.10-5.27). Recurrence hazard was not significantly changed among digoxin-using women also using tamoxifen. CONCLUSIONS: Breast cancers arising in digoxin-using women had better prognostic features. After adjustment for markers, overall breast cancer relapse risk in digoxin users was not increased significantly, although recurrence hazards for ER+ tumors were higher in the first year following diagnosis.
    Breast cancer research: BCR 02/2013; 15(1):R13. · 5.87 Impact Factor
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    ABSTRACT: To examine the development of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain. Repeated cross sectional study in a previously examined nationwide cohort. All eligible women who underwent surgery for primary breast cancer in Denmark in 2005 and 2006 and were examined in 2008 were surveyed again with the same questionnaire. SETTING : Surgical centres in Denmark. MAIN OUTCOME MEASURES : Prevalence, location, and severity of persistent pain after treatment for breast cancer in well defined treatment groups and changes in pain reporting and sensory disturbances from 2008 to 2012. PARTICIPANTS : In 2012, 2828 women were eligible in our database, and 108 were excluded. Exclusion criteria were death; new, recurrent, or other cancer; reconstructive breast surgery; and emigration. RESULTS : 2411 (89%) women returned the questionnaire. Prevalence of persistent pain after treatment for breast cancer ranged from 22% to 53% depending on treatment. In 2012, 903 (37%) women reported such pain, a fall from 45% in 2008. Of these, 378 (16%) reported pain of ≥4 on a numerical rating scale (scale 0-10), a fall from 19%. Among women reporting pain in 2008, 36% no longer reported it in 2012. In contrast, 15% of the women who did not report pain in 2008 reported it in 2012. Risk factors for having pain were axillary lymph node dissection rather than sentinel lymph node biopsy (odds ratio 2.04, 95% confidence interval 1.60 to 2.61; P<0.001) and age ≤49 (1.78, 1.25 to 2.54; P<0.001). No particular method of treatment or age was associated with an increase in pain from 2008 to 2012. Persistent pain after treatment for breast cancer remains an important problem five to seven years later. The problem is not static as it can either progress or regress with time. TRIAL REGISTRATION : Clinicaltrials.gov NCT No 01543711.
    BMJ (Clinical research ed.). 01/2013; 346:f1865.
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    ABSTRACT: Breast cancer is a very heterogeneous disease, encompassing several intrinsic subtypes with various morphological and molecular features, natural history and response to therapy. Currently, molecular targeted therapies are available for estrogen receptor (ER)- and human epidermal growth factor receptor 2 (Her2)-positive breast tumors. However, a significant proportion of primary breast cancers are negative for ER, progesterone receptor (PgR), and Her2, comprising the triple negative breast cancer (TNBC) group. Women with TNBC have a poor prognosis due to the aggressive nature of these tumors and current lack of suitable targeted therapies. As a consequence, the identification of novel relevant protein targets for this group of patients is of great importance. Using a systematic 2D gel-based proteomic profiling strategy, applied to the analysis of fresh TNBC tissue biopsies, in combination with a three-tier orthogonal technology (2D PAGE/silver staining coupled with MS, 2D Western blotting, and immunohistochemistry) approach, we aimed to identify targetable protein markers that were present in a significant fraction of samples and that could define therapy-amenable sub-groups of TNBCs. We present here our results, including a large cumulative database of proteins based on the analysis of 78 TNBCs, and the identification and validation of one specific protein, Mage-A4, which was expressed in a significant fraction of TNBC and Her2-positive/ER negative lesions. The high level expression of Mage-A4 in the tumors studied allowed the detection of the protein in the tumor interstitial fluids as well as in sera. The existence of immunotherapeutics approaches specifically targeting this protein, or MAGE-A protein family members, and the fact that we were able to detect its presence in serum suggest novel management options for TNBC and Her2 positive/ER negative patients bearing Mage-A4 positive tumors.
    Molecular &amp Cellular Proteomics 11/2012; · 7.25 Impact Factor
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    ABSTRACT: PURPOSEWe questioned the impact of pregnancy on disease-free survival (DFS) in women with history of breast cancer (BC) according to estrogen receptor (ER) status. PATIENTS AND METHODSA multicenter, retrospective cohort study in which patients who became pregnant any time after BC were matched (1:3) to patients with BC with similar ER, nodal status, adjuvant therapy, age, and year of diagnosis. To adjust for guaranteed time bias, each nonpregnant patient had to have a disease-free interval at least equal to the time elapsing between BC diagnosis and date of conception of the matched pregnant one. The primary objective was DFS in patients with ER-positive BC. DFS in the ER-negative cohort, whole population, and overall survival (OS) were secondary objectives. Subgroup analyses included DFS according to pregnancy outcome and BC-pregnancy interval. With a two-sided α = 5% and β = 20%, 645 ER-positive patients were required to detect a hazard ratio (HR) = 0.65.ResultsA total of 333 pregnant patients and 874 matched nonpregnant patients were analyzed, of whom 686 patients had an ER-positive disease. No difference in DFS was observed between pregnant and nonpregnant patients in the ER-positive (HR = 0.91; 95% CI, 0.67 to 1.24, P = .55) or the ER-negative (HR = 0.75; 95% CI, 0.51 to 1.08, P = .12) cohorts. However, the pregnant group had better OS (HR = 0.72; 95% CI, 0.54 to 0.97, P = .03), with no interaction according to ER status (P = .11). Pregnancy outcome and BC-pregnancy interval did not seem to impact the risk of relapse. CONCLUSION Pregnancy after ER-positive BC does not seem to reduce the risk of BC recurrence.
    Journal of Clinical Oncology 11/2012; · 18.04 Impact Factor
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    ABSTRACT: Background Axillary treatment of breast cancer patients is undergoing a paradigm shift, as completion axillary lymph node dissections (ALNDs) are being questioned in the treatment of patients with tumor-positive sentinel nodes. This study aims to develop a novel multi-institutional predictive tool to calculate patient-specific risk of residual axillary disease after tumor-positive sentinel node biopsy.Methods Breast cancer patients with a tumor-positive sentinel node and a completion ALND from five European centers formed the original patient series (N = 1000). Statistically significant variables predicting nonsentinel node involvement were identified in logistic regression analysis. A multivariable predictive model was developed and validated by area under the receiver operating characteristics curve (AUC), first internally in 500 additional patients and then externally in 1068 patients from other centers. All statistical tests were two-sided.ResultsNine tumor- and sentinel node-specific variables were identified as statistically significant factors predicting nonsentinel node involvement in logistic regression analysis. A resulting predictive model applied to the internal validation series resulted in an AUC of 0.714 (95% confidence interval [CI] = 0.665 to 0.763). For the external validation series, the AUC was 0.719 (95% CI = 0.689 to 0.750). The model was well calibrated in the external validation series.Conclusions We present a novel, international, multicenter, predictive tool to assess the risk of additional axillary metastases after tumor-positive sentinel node biopsy in breast cancer. The predictive model performed well in internal and external validation but needs to be further studied in each center before application to clinical use.
    CancerSpectrum Knowledge Environment 11/2012; · 14.07 Impact Factor
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    ABSTRACT: BACKGROUND: Patients treated with 2-step axillary lymph node dissection (ALND) may be at increased risk of nerve damage due to more challenging surgery than an ALND immediately after a sentinel lymph node biopsy (SLNB), and thus more at risk for persistent pain after breast cancer treatment (PPBCT). The aim of this study was to examine PPBCT, sensory disturbances and functional impairment in patients treated with a 2-step ALND compared to patients with an SLNB followed by an immediate ALND, and patients with ALND without a prior SLNB. METHODS: The study is a cross-sectional questionnaire study, comparing 2847 women treated with ALND in Denmark in 2005-2008. 196 patients treated with a 2-step ALND were compared with 1558 patients treated with an ALND after SLNB and 1093 with an ALND without a prior SLNB. RESULTS: Overall prevalence of PPBCT and sensory disturbances was high, with about 55% reporting PPBCT and 77% reporting sensory disturbances in all groups. No differences were found between the groups on prevalence and intensity of PPBCT (p = 0.92), sensory disturbances (p = 0.32), and functional consequences (p = 0.35). CONCLUSIONS: A 2-step ALND does not modify the risk of developing PPBCT compared to an immediate ALND.
    European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 10/2012; · 2.56 Impact Factor
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    ABSTRACT: During the past 50 years, breast cancer incidence has increased by 2-3 % annually. Despite many years of testing for estrogen receptors (ER), evidence is scarce on breast cancer incidence by ER status. The aim of this paper was to investigate the increase in breast cancer incidence by ER status. Data were obtained from the clinical database of the Danish Breast Cancer Cooperative Group which holds nationwide data on diagnosis, including pathology, treatment, and follow-up on primary breast cancers since 1977. All Danish women <80 years diagnosed with primary breast cancer 1996-2007 were identified in this prospective register based study. ER status was evaluated using immunohistochemical staining by standardized laboratory methods in the Danish Pathology Departments and reported to the database. From 1996 to 2007, breast cancer incidence increased overall with a tendency to level off after 2002. In all women a significant decrease was found in ER unknown tumors. However, in both pre- and postmenopausal women, significant increases were seen in incidence of ER+ tumors; though the increase levelled off for premenopausal women after 2002. In postmenopausal women, the incidence of ER- breast cancer decreased significantly throughout the period. In women <35 years, we found a minor non-significant increase in both ER+ and ER- tumors. ER unknown decreased in all women and was the most distinct in premenopausal women aged 35+. We found a significant increase in ER+ breast cancer incidence in postmenopausal women whereas the incidence in premenopausal women (aged 35+) levelled off after 2002.
    Breast Cancer Research and Treatment 09/2012; · 4.47 Impact Factor
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    ABSTRACT: Abstract Background. Breast cancer is the most common cancer among Danish women. Locally advanced breast cancer occurs in a relatively large proportion of all new primary breast cancer diagnoses and for unexplained reasons 20-30% of women with breast cancer wait more than eight weeks from the initial breast cancer symptom(s) before seeking medical advice. Material and methods. In this study, we performed a retrospective review of the medical records of patients referred to The Department of Breast Surgery, Rigshospitalet in Copenhagen in the period between 2006 and 2011, to characterize women presenting with breast cancer either larger than 5 cm or locally advanced breast cancer/inoperable breast cancer (LABC/IOBC). The aim of the study was to characterize these women concerning age, social status, co-morbidity, defined anamnestic parameters concerning breast history and delay in seeking medical advice, to explore whether common traits among these parameters could be identified which could account for the late diagnosis. Results. We identified 157 cases. The median age of our cohort was 67 years (range 30-98) and did not differ from all women with breast cancer, but with a high risk of severe medical co-morbidity, psychiatric co-morbidity or dementia. However, 42% did not reveal any history of a psychiatric or somatic co-morbidity did not take psychoactive drugs and had no previous benign breast disorder. They were living in their own homes, were married, did not suffer from dementia, could have a first-degree relative with a history of breast cancer, but still presented with breast cancer characterized as LABC/IOBC, without any apparent reason. Among these 42%, more than half had neglected their obvious symptoms of breast cancer.
    Acta oncologica (Stockholm, Sweden) 08/2012; 51(8):1081-5. · 2.27 Impact Factor
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    ABSTRACT: The Danish national mammography screening programme leads to identification of an increased number of small non-palpable breast tumours, suitable for breast-conserving surgery. Accurate lesion localization is therefore important. The current standard is wire-guided localization and although effective it involves a risk of high rates of positive margin and re-operations. New methods are emerging and radioactive seed localization (RSL) seems promising with regards to re-operation rates and logistics. In RSL a small titanium seed containing radioactive iodine is used to mark the lesion.
    Ugeskrift for laeger 08/2012; 174(34):1891-4.

Publication Stats

904 Citations
269 Downloads
349.48 Total Impact Points

Institutions

  • 2010–2014
    • Copenhagen University Hospital
      København, Capital Region, Denmark
    • IT University of Copenhagen
      København, Capital Region, Denmark
  • 2009–2014
    • University of Copenhagen
      • Surgical Pathophysiology Unit
      København, Capital Region, Denmark
  • 2011–2013
    • Region Hovedstaden
      Hillerød, Capital Region, Denmark
  • 2012
    • Ringsted Sygehus
      Ringsted, Zealand, Denmark
  • 2009–2012
    • Rigshospitalet
      • Department of Oncology
      Copenhagen, Capital Region, Denmark
  • 2010–2011
    • Aarhus University Hospital
      • • Breast and Endocrine Section
      • • Department of Clinical Epidemiology
      Aarhus, Central Jutland, Denmark
  • 2008
    • Herlev Hospital
      • Department of Pathology
      Herlev, Capital Region, Denmark
  • 2005–2008
    • University of Copenhagen Herlev Hospital
      Herlev, Capital Region, Denmark
  • 1996–2007
    • Statens Serum Institut
      • Department of Epidemiology Research
      København, Capital Region, Denmark
  • 2004
    • Karolinska Institutet
      Solna, Stockholm, Sweden
  • 2000
    • Breakthrough Breast Cancer
      Londinium, England, United Kingdom
  • 1997
    • Hillerød Hospital
      Hillerød, Capital Region, Denmark