Researchers studied 714 864 women with breast cancer diagnosed in 2001–2013, from 23 population-based registries in 14 European countries. Stage from three TNM editions was converted to seventh-edition stages I–IV, and survival used 2010–2014 period analysis. Age-adjusted 10-year relative survival fell from 97% in stage I to 82%, 51% and 10% in stages II–IV. Stage IV survival ranged from 3% in Northern Ireland to 22% in Switzerland, while stage I varied little. Limitations include 59 registries dropped for missing stage, low coverage in Italy and Spain, and no treatment data. Converting between TNM editions may also have moved some cases between stages, known as stage migration.
Why it is interesting: Earlier conversion algorithms merged stages II and III into one regional group. Here, a four-level stage shows gaps between countries mainly in advanced disease, while stage I survival is close to uniform.
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