by Laurie Skokan, Ph.D., Providence Health and Services, Oregon Region, Cancer Registry Director
Women diagnosed with breast cancer face a tough battle, but statistics from Providence Health & Services, the Oregon State Cancer Registry and the National Cancer Database show that the likelihood of surviving three years after being diagnosed with stage III or stage IV disease is greater when women are treated at Providence Cancer Center.
Providence Health & Services Portland Service Area treats 20% of all breast cancer diagnosed in the state of Oregon and 53.8% of those diagnosed in the Portland Service area. In 2003, PHS treated 630 newly diagnosed breast cancers. In 2005 we treated 701 newly diagnosed breast cancers, 392 of them at Providence St. Vincent Medical Center, home of the Ruth J. Spear Breast Center.
PHS diagnoses 58.9% of breast cancers at the earliest stage (0 and 1) as compared to 56.4% nationally. PSVMC does even better, diagnosing 60.2% of cancers in the earliest stages.
For cancers diagnosed in the earliest stages, breast conservation surgery (BCS) plus radiation is equivalent to a modified radical mastectomy in terms of survival. Many systems and breast centers use percentage of breast-conserving surgery as a quality indicator. Overall, the BCS rate at PHS is 65.9%, compared to 58.2% nationally and to 48.4% in the state of Oregon. Looking at the numbers by stage, 67.1% of patients with in situ disease have BCS, 77.2% of patients with stage 1 disease, and 63.7% of patients with stage 3 disease.
With respect to three-year survival, Providence compares favorably to National Cancer Database and Oregon State Cancer Registry statistics. The numbers by stage look like this:
Stage
Providence
Oregon
National
0
98.7 n=162
97.1
97.1
1
98.9 n=564
95.7
94.6
2
97.1 n=380
90.1
89.0
3
87.5 n=150
77.0
70.2
4
61.4 n=22
36.0
32.0
The numbers of stage 4 patients in the above table are low, so every death impacts survival dramatically. Stages 0, 1, and 2 are insignificant differences, but the trend is certainly going in the right direction. The difference in survival for stage 3 patients is significant and stage 3 and 4 taken together are significantly better than either national or Oregon data.
Laurie A. Skokan, Ph.D., serves as the health behavior psychologist at the Robert W. Franz Cancer Research Center in the Earle A. Chiles Research Institute at Providence Portland Medical Center. Her areas of expertise include research methodology, health psychology, outcomes measurement and statistical analysis. Dr. Skokan earned her Ph.D. in Social Psychology at the University of California, Los Angeles. In addition to her work at the Robert W. Franz Cancer Research Center, Dr. Skokan manages the Providence Health & Services regional cancer registry.
