Background: To describe the overall and disease-free survival at five and ten years after breast cancer diagnosis in women from a previous case-control study, and establish related prognostic factors. Methods: We followed up 202 patients diagnosed between 1996 and 1998 in three public hospitals in Granada and Almeria provinces in Spain. Survival rates were calculated using the Kaplan and Meier method, and the Cox proportional hazards model was applied to identify the most significant variables contributing to survival. Results: Mean age at diagnosis was 54.27±10.4 years. Mean follow-up for overall survival was 119.91 months (95%CI 113.65-126.17); the five-year survival rate was 83.9% (95%CI: 78.13-89.66) and the ten-year rate was 71% (95%CI: 63.25-78.74). Mean follow-up for disease-free survival was 118.75 months (95%CI 111.86-125.65); the five-year disease-free survival rate was 81% (95%CI: 74.52-87.47) and the ten-year rate was 71.3% (95%CI: 63.33-79.26). The mortality rate of the study population was 33.17%. Conclusions: Disease characteristics are similar in our population to those in other Spanish and European regions, while the overall survival is higher than the mean rate during the same period in Europe (5-yr rate of 79%) and similar to that in Spain (83%).

Fundamento: Describir la supervivencia global y libre de enfermedad a los cinco y diez años del diagnóstico de cáncer de mama en mujeres participantes un estudio caso control previo, y establecer las variables pronóstico relacionadas. Métodos: Se realizó el seguimiento de 202 mujeres diagnosticadas en tres hospitales públicos de Granada y Almería entre 1996-1998. La supervivencia se evaluó mediante el método de Kaplan-Meier, y la identificación de factores relacionados mediante el análisis de regresión de Cox. Resultados: La edad media al diagnóstico fue de 54,27±10,4 años. La supervivencia global a los 5 años fue del 83,9% (IC 95%: 78,13-89,66) y a los 10 años del 71% (IC 95%: 63,25-78,74) con un tiempo medio de seguimiento de 119,91 meses (IC 95% 113,65-126,17). La supervivencia libre de enfermedad a los 5 años fue del 81% (IC 95%: 74,52-87,47) y a los 10 años del 71,3% (IC 95%: 63,33-79,26) con un tiempo medio de seguimiento de 118,75 meses (IC 95% 111,86-125,65). La mortalidad de la serie fue del 33'17%. Conclusiones: Las características de la enfermedad en las mujeres de la muestra estudiada son similares a las de otras regiones de España y Europa, con una supervivencia global superior a la descrita en Europa y y comparable a la de España amba referidas para el mismo periodo.

Background: To describe the overall and disease-free survival at five and ten years after breast cancer diagnosis in women from a previous case-control study, and establish related prognostic factors. Methods: We followed up 202 patients diagnosed between 1996 and 1998 in three public hospitals in Granada and Almeria provinces in Spain. Survival rates were calculated using the Kaplan and Meier method, and the Cox proportional hazards model was applied to identify the most significant variables contributing to survival. Results: Mean age at diagnosis was 54.27±10.4 years. Mean follow-up for overall survival was 119.91 months (95%CI 113.65-126.17); the five-year survival rate was 83.9% (95%CI: 78.13-89.66) and the ten-year rate was 71% (95%CI: 63.25-78.74). Mean follow-up for disease-free survival was 118.75 months (95%CI 111.86-125.65); the five-year disease-free survival rate was 81% (95%CI: 74.52-87.47) and the ten-year rate was 71.3% (95%CI: 63.33-79.26). The mortality rate of the study population was 33.17%. Conclusions: Disease characteristics are similar in our population to those in other Spanish and European regions, while the overall survival is higher than the mean rate during the same period in Europe (5-yr rate of 79%) and similar to that in Spain (83%).

Fundamento: Describir la supervivencia global y libre de enfermedad a los cinco y diez años del diagnóstico de cáncer de mama en mujeres participantes un estudio caso control previo, y establecer las variables pronóstico relacionadas. Métodos: Se realizó el seguimiento de 202 mujeres diagnosticadas en tres hospitales públicos de Granada y Almería entre 1996-1998. La supervivencia se evaluó mediante el método de Kaplan-Meier, y la identificación de factores relacionados mediante el análisis de regresión de Cox. Resultados: La edad media al diagnóstico fue de 54,27±10,4 años. La supervivencia global a los 5 años fue del 83,9% (IC 95%: 78,13-89,66) y a los 10 años del 71% (IC 95%: 63,25-78,74) con un tiempo medio de seguimiento de 119,91 meses (IC 95% 113,65-126,17). La supervivencia libre de enfermedad a los 5 años fue del 81% (IC 95%: 74,52-87,47) y a los 10 años del 71,3% (IC 95%: 63,33-79,26) con un tiempo medio de seguimiento de 118,75 meses (IC 95% 111,86-125,65). La mortalidad de la serie fue del 33'17%. Conclusiones: Las características de la enfermedad en las mujeres de la muestra estudiada son similares a las de otras regiones de España y Europa, con una supervivencia global superior a la descrita en Europa y y comparable a la de España amba referidas para el mismo periodo.

Este artigo apresenta uma análise das opiniões de diferentes grupos, inclusive de cientistas, agências regulatórias internacionais, organizações não-governamentais e indústrias, interessados na questão da identificação de substâncias químicas com atividade desreguladora endócrina. Os autores discutem também o impacto da exposição aos desreguladores endócrinos sobre a saúde humana, considerando as seguintes questões: estimativa de risco; testes utilizados para detectar distúrbios endócrinos; dificuldades na identificação de uma associação entre dose, tempo de exposição, suscetibilidade individual e efeito e tentativas no sentido de mapear os desreguladores endócrinos. Finalmente, os autores argumentam que nem todos os agonistas hormonais devem ser incluídos sob a denominação genérica de desreguladores endócrinos.

This paper presents an analysis of the opinions of different groups from: scientists, international regulatory bodies, non-governmental organizations and industry; with an interest in the problem of identifying chemical substances with endocrine disrupting activity. There is also discussion of the consequences that exposure to endocrine disruptors may have for human health, considering concrete issues related to: the estimation of risk; the tests that must be used to detect endocrine disruption; the difficulties to establish an association between dose, time of exposure, individual susceptibility, and effect; and the attempts to create a census of endocrine disruptors. Finally, it is proposed that not all hormonal mimics should be included under the single generic denomination of endocrine disruptors.

Este artigo apresenta uma análise das opiniões de diferentes grupos, inclusive de cientistas, agências regulatórias internacionais, organizações não-governamentais e indústrias, interessados na questão da identificação de substâncias químicas com atividade desreguladora endócrina. Os autores discutem também o impacto da exposição aos desreguladores endócrinos sobre a saúde humana, considerando as seguintes questões: estimativa de risco; testes utilizados para detectar distúrbios endócrinos; dificuldades na identificação de uma associação entre dose, tempo de exposição, suscetibilidade individual e efeito e tentativas no sentido de mapear os desreguladores endócrinos. Finalmente, os autores argumentam que nem todos os agonistas hormonais devem ser incluídos sob a denominação genérica de desreguladores endócrinos.

This paper presents an analysis of the opinions of different groups from: scientists, international regulatory bodies, non-governmental organizations and industry; with an interest in the problem of identifying chemical substances with endocrine disrupting activity. There is also discussion of the consequences that exposure to endocrine disruptors may have for human health, considering concrete issues related to: the estimation of risk; the tests that must be used to detect endocrine disruption; the difficulties to establish an association between dose, time of exposure, individual susceptibility, and effect; and the attempts to create a census of endocrine disruptors. Finally, it is proposed that not all hormonal mimics should be included under the single generic denomination of endocrine disruptors.