On this basis, our analysis is expected to underestimate the actual number of breast cancer VRT752271 incident cancer cases. Currently, the percentage of breast cancer patients who are metastatic at diagnosis approximates 6%, with a

5-year survival rate of 21% [19]. We analyzed data related to the time frame spanning from 2001 to 2008. Variations in admitting practices and treatment protocols for the disease of interest might have occurred over time and by area. In few cases, this could have caused discrepancies between the selleck kinase inhibitor hospital discharges and the actual occurrence of the disease considered [20, 21]. Notwithstanding the exclusion of incident cases of metastatic breast cancer (by inclusion criteria), the rates obtained from the analysis of the hospital discharge records were higher than those reported by the Italian Ministry of Health in 2006. According to the CRs 2006 report, the number of estimated breast cancer cases for TGF-beta inhibitor the year 2006 was 37,542 [22]. In the same year, we observed 42,258 cases (i.e., +11%). Several factors might contribute to such a discrepancy.

First, in our study the linking process allowed the discharge of repeat hospital admission between 2001 and 2008, but discharge data related to patients who had been admitted for breast cancer in years prior to 2001 might still be present. Indeed, 10–15 percent of patients undergoing breast conservative therapy for operable breast cancer (i.e., breast-conserving surgery and postoperative breast irradiation) will develop a loco-regional recurrence within 10 years [23]. This risk is slightly higher than that of a loco-regional recurrence following mastectomy (5 to 10 percent) [23, 24]. However, these rates include both metastases occurring in the ipsilateral preserved breast (i.e., local recurrence)

and regional lymph nodes, (i.e., regional recurrence), with only the first representing a potential target for breast surgery. Second, our analysis included data on carcinoma in situ of the (-)-p-Bromotetramisole Oxalate breast, which are not routinely collected and analyzed by CRs [17]. Third, the official estimates were based on the use of the Mortality and Incidence Analysis Model method (MIAMOD), a back-calculation approach which obtains cancer-specific morbidity measures by using official mortality data and model-based relative survival from local cancer registry data. As such, the MIAMOD method reflects the limitations stemming from the incomplete coverage and disproportion among macro-areas which characterize the Italian network of CRs [10]. On this basis, underreporting of cases and, consequently, underestimation of the cancer burden cannot be excluded when using the MIAMOD approach. Significant increases in quadrantectomies were reported in women aged 25 to 39 and 40 to 44 years.