Intended for healthcare professionals

Bmj Usa: Minerva


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E29

This article originally appeared in BMJ USA

A retrospective look at a cohort of American women with breast cancer suggests that survival can be reasonable even when the disease has spread to bone (Cancer 2001;91:17–24. Women with a solitary bony metastasis survived more than four years, on average, from the time of recurrence. Survival gets steadily worse, however, as the number of metastases goes up. In this cohort, recruited between 1974 and 1985, women with two bony lesions lived for three years, and those with more than three metastases lived only two years after recurrence.

Another study on breast cancer, this time comparing survival rates in different types of hospitals, confirms again that patients do better in teaching hospitals (Canadian Medical Association Journal 2001;164:183–188. The Canadian researchers, who included only women with node negative disease, conclude that for women with tumours less than 20 mm in diameter, initial treatment in a teaching hospital reduces the risk of death by 53%. The difference was smaller, and not significant, for women with larger tumours.

Every now and then people in a deep coma are wrongly declared dead, and survive the …

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