Has tumor doubling time in breast cancer changed over the past 80 years? A systematic review

• Published in: Cancer medicine (Malden, MA) Vol. 10; no. 15; pp. 5203 - 5217
• Main Authors: Dahan, Meryl, Hequet, Delphine, Bonneau, Claire, Paoletti, Xavier, Rouzier, Roman
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.08.2021; Wiley; John Wiley and Sons Inc
• Subjects: Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Cancer Biology; Cell cycle; Cell Proliferation; Epidemiology; Epidermal growth factor; Female; Growth rate; Hormone replacement therapy; Humans; Ki-67 Antigen - metabolism; Life Sciences; Lymphatic system; Mammography; Mass Screening; Medical prognosis; molecular subtypes; Overdiagnosis; Patients; Receptor, ErbB-2 - metabolism; Regression Analysis; Review; Risk factors; screening; Systematic review; Time Factors; Triple Negative Breast Neoplasms - pathology; Tumor Burden; tumor doubling time; tumor growth rate; Tumors; tumor doubling time; molecular subtypes; breast cancer; screening; tumor growth rate
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.3939

Over the past century, epidemiologic changes and implementation of screening may have had an impact on tumor doubling time in breast cancer. Our study was designed to evaluate changes in tumor doubling time in breast cancer over the past 80 years. A systematic review of published literature and meta‐regression analysis was performed. An online electronic database search was undertaken using the PubMed platform from inception until June 2020. All studies that measured tumor doubling time in breast cancer were included. A total of 151 publications were retrieved. Among them, 16 full‐text articles were included in the qualitative analysis. An exponential growth model was used for quantitative characterization of tumor growth rate. Tumor doubling time has remained stable over the past 80 years. Recent studies have not only identified “fast growing tumor” (grade 3, human epidermal growth factor receptor 2‐positive, triple‐negative, or tumor with an elevated Ki‐67) but also “inactive breast cancer” feeding the ongoing debate of overdiagnosis due to screening programs. The stability of tumor doubling time over the past 80 years, despite increasing and changing risk factors, supports the validity for our screening guidelines. Prospective studies based on more precise measurement of tumor size and adjustment for tumor characteristics are necessary to more clearly characterize the prognostic and predictive impact of tumor doubling time in breast cancer. The stability of tumor doubling time over the past 80 years, despite increasing and changing risk factors, supports the validity of our screening guidelines. Recent studies have not only identified “fast growing tumor” but also “inactive breast cancer” feeding the ongoing debate of overdiagnosis due to screening programs.