S265
Clinical - Breast
ESTRO 2026
95% CI 0.271-0.394, p<0.001).(Table 1)Other independent poor prognostic factors included positive nodal status (HR 1.529), higher grade (G3 HR 2.996), and Basal (Triple-Negative) subtype (HR 1.490). Of note, after adjusting for other factors, the HER2- enriched subtype (HR 1.019, 95% CI 0.870-1.193, p=0.815) was not prognostically different from the Luminal A reference.
Trial is Recruiting. Clin Oncol (R Coll Radiol). 2023 Jun;35(6):347-350. doi: 10.1016/j.clon.2023.02.015. PMID: 36933970.PARABLE Trial ISRCTN: 14220944 Keywords: Proton beam therapy, breast cancer, trial design
Digital Poster Highlight 2056
Quantifying 20 Years of Breast Cancer Survival Gains in Singapore: A Multivariable Analysis Chuan Yaw Lee 1 , Elaine Lim 1 , Nitar Phyu 2 , Shun Zi Liong 3 , Fuh Yong Wong 4,2 , for the Joint Breast Cancer Registry Investigators 2 1 Division of Medical Oncology, National Cancer Centre of Singapore, Singapore, Singapore. 2 Department of Cancer Informatics, National Cancer Centre of Singapore, Singapore, Singapore. 3 CTE-Biostatistics Unit, National Cancer Centre of Singapore, Singapore, Singapore. 4 Division of Radiation Oncology, National Cancer Centre of Singapore, Singapore, Singapore Purpose/Objective: To evaluate the 20-year temporal trend of 8-year cancer-specific survival (CSS) for non-metastatic breast cancer in Singapore. The primary aim was to quantify the magnitude of survival improvement over time and to determine if this trend was an independent prognostic factor, distinct from known drivers like stage migration and shifts in biological subtype. Material/Methods: We identified 16,041 female patients with first- primary, non-metastatic (Stage I-III) invasive breast cancer diagnosed from 1 Jan 1999 to 31 Dec 2019 from the population-based Joint Breast Cancer Registry (JBCR).(1) The median follow-up for the cohort was 10.0 years (IQR: 6.3 – 15.1). The cohort was stratified into seven 3-year intervals (e.g., 1999-2001, 2002-2004, etc.). The primary endpoint was 8-year CSS, calculated using the Kaplan-Meier method; univariate analysis (UVA) was performed using the Log-rank test. A multivariable (MVA) Cox proportional hazards model was constructed to test the independent prognostic value of the diagnostic period, adjusting for age, race, anatomic stage, nodal status, histological grade, and histological subtype. Results: Overall 8-year CSS for the entire cohort improved significantly and progressively, from 81.0% (95% CI 78.7-83.4) in the 1999-2001 interval to 92.4% (95% CI 91.4-93.4) in the 2017-2019 interval (p<0.001). This improvement was consistent across all stages and subtypes. (Figure 1)On MVA, a later diagnostic period was the strongest independent predictor of improved CSS. Compared to the 1999-2001 reference, patients in the 2017-2019 interval had a 67.3% reduction in the hazard of breast cancer death (Adjusted HR: 0.327,
Conclusion: Breast cancer CSS in Singapore has improved dramatically over the last 20 years. This survival gain represents a strong, independent trend that persists after correction for stage migration and case-mix, confirming the profound impact of the evolution of multidisciplinary standards of care. The neutralization of the historically poor prognosis of HER2-enriched disease exemplifies the successful real-world implementation of targeted therapies. This study provides a powerful model of the success of guideline- driven cancer care in a multi-ethnic Asian population. References: 1. Wong FY, Chua BJG, Dent R, Hartman M, Lim GH, Lim SZ, et al. Advancing breast cancer research through real-world data from the Singapore Joint Breast Cancer Registry. ESMO Real World Data and Digital Oncology. 2025 Sep;9:100159. Keywords: Real-World Evidence, Subtype, Targeted Therapy
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