Comprehensive trends in incidence, treatment, survival and mortality of first primary invasive breast cancer stratified by age, stage and receptor subtype in the Netherlands between 1989 and 2017

This study aimed to provide a comprehensive overview of trends in incidence, survival, mortality and treatment of first primary invasive breast cancer (BC), according to age, stage and receptor subtype in the Netherlands between 1989−2017. Data from all women diagnosed with first primary stage I−IV breast cancer (N=320,249) were obtained from the Netherlands Cancer Registry. BC mortality and general population data were retrieved from Statistics Netherlands. Age‐standardized incidence and mortality rates were calculated with annual and average annual percentage change statistics (APC and AAPC). The relative survival (RS) was used as estimator for disease‐specific survival. The BC incidence for all BC patients combined increased until 2013 from 126 to 158 per 100,000 person‐years, after which a declining trend was observed. Surgery became less extensive, but (neo)adjuvant systemic treatments and their combinations were given more frequently. The RS improved for all age groups and for most stages and receptor subtypes, but remained stable for all subtypes since 2012−2013 and since 2000−2009 for stage IV BC at 15−years of follow‐up. Overall, the five‐ and ten‐year RS increased from 76.8% (95% confidence interval [CI]:76.1, 77.4) and 55.9% (95%CI:54.7, 57.1) in 1989−1999 to 91.0% (95%CI:90.5, 91.5) and 82.9% (95%CI:82.2, 83.5), respectively, in 2010−2016. BC mortality improved regardless of age and overall decreased from 57 to 35 per 100,000 person‐years between 1989−2017. In conclusion, the BC incidence in the Netherlands has steadily increased since 1989, but the latest trends show promising declines. Survival improved markedly for most patients and the mortality decreased regardless of age.