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Breast and gastric cancer.

Romeo Giuli MD, resident.
School of General and Emergency Surgery.
University of Siena.   Italy.

August 2002.     Review Article.

Worldwide, breast cancer and gastric cancer are the most common malignancies, but their incidence differs substantially in the United States and Japan. In the United States, 203,500 new breast cancer cases versus only 21,600 new gastric cancer cases are estimated to occur in 2002 (, cancer statistics). By contrast, in Japan, the breast cancer lifetime risk among women is much lower than that in the United States (1 of 81 vs. 1 of 8), whereas the incidence of gastric cancer in Japan, one of the highest in the world, is 50 vs. only 8.7 per 100,000 in the United States.

The current clinical management of breast and gastric cancer involves a broad spectrum of treatment options from minimally invasive approaches for early-stage cancers to combined multimodality approaches with pre or postoperative adjuvant treatment in locally-advanced or non-early-stage cancers.

The completely diverged progress in research and clinical management of breast and gastric cancer in the United States and Japan is likely to be attributable largely to the diverse incidence rates, research attention, and funding from public health and pharmaceutical companies in each country.
The lesson we can learn from such a comparison is that early detection through screening mammography and endoscopy for breast and gastric cancer, respectively, is now the most effective intervention toward an improvement of both survival and QOL. Promising findings in cancer genetics and advanced screening and therapeutic technology suggest that it is time to focus more on prediction, prevention, early detection, and minimally invasive approaches rather than conventional, empirical, and multidisciplinary cancer therapeutics of late detected advanced-stage cancers ( 1 ).


1) Dimitrios H. Roukos et al. Breast and Gastric Cancer: Comparing What We Learn. Annals of Surgical Oncology 2003, 10(1):92-94.

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