DBCG (Danish Breast Cancer Cooperative Group) constitutes a multidisciplinary organization established in 1975 by the Danish Surgical Society. The purpose involves first and foremost a nation-wide standardization of breast cancer treatment based on novel therapeutic principles, collaboration between experts handling diagnostic work-up, surgery, radiotherapy, medical oncology, and basic research, and, further, complete registration of relevant clinical data in a national data base attached to DBCG. Data are processed by the Secretariat personnel composed of statisticians, data managers, and data secretaries making current analyses of outcome results feasible. DBCG is run by the Executive Committee consisting of expert members appointed by their respective society. From 1978 the DBCG project gained widely accession from participating units, and since then nearly all newly diagnosed breast cancer incident cases are reported and registered in the national data base. Today, the data base includes approximately 80 000 incidents of primary breast cancer. Annually, the Secretariat receives roughly 1.5 million parameters to be entered into the data base. Over time DBCG has generated seven treatment programmes including in situ lesions and primary invasive breast cancer. Probands are subdivided into risk groups based on a given risk pattern and allocated to various treatment programmes accordingly. The scientific initiatives are conducted in the form of register- and cohort analysis or randomized trials in national or international protocolized settings. Yearly, about 4 000 new incident cases of primary invasive breast cancer and about 200 in situ lesions enter the national programmes. Further, about 600 women with hereditary disposition of breast cancer are registered and evaluated on a risk scale. The main achievements resulted in a reduction of relative risk of death amounting up to 20% and increased 5-year overall survival ascending from 60% to roughly 80%. This article is partly based on a Danish paper to be published in the Centenary Jubilee book of the Danish Surgical Society, 2008.
The last 50 years of development in gynecological oncology has changed the methods for the diagnosis of cancer and for treatment of cancer, both to give better treatment results. From the beginning the gynecologist could only inspect or palpate. Later on roentgen examination was introduced and later still microscopic diagnosis, more advanced diagnostic methods, e.g. endoscopy, ultrasound, isotope examination and advanced microscopic diagnosis and computerized tomography. Today we are waiting for the break-through in computerized tomography using nuclear spin resonance for the study of tumors and the spread of tumors. Parallel with the development in diagnosis, treatment has developed. Originally surgery was the only method available. Later on low energy radiation, endocrine therapy, chemotherapy and then high voltage energy treatment became available along with some experimental therapies. Today we have a broad range of therapeutic tools to use. In the future we might use prophylaxis more than we do today to prevent cancer and when cancer is present we might enhance the immune defense or introduce specific immuno-therapy with clonal antibodies, specially made for the actual tumor, and surgery, radiotherapy and chemotherapy will be used less.
This review highlights major achievements of the Russian oncology in the past decades, such as works of N.N. Petrov, L.A. Zilber, N.N. Blokhin, E.E. Pogosyants. Revolutionary shift in the understanding of the malignization process have become possible after decoding of human genome, as well as genome of several tumors such as breast cancer, acute myeloblastic leukemia, several brain tumors, testicular cancer and other neoplasms. The issue of stem cells being possible ancestors of tumor cells is also discussed in the review. Also the author observes main modern therapeutic approaches towards cancer treatment. It is specially highlighted that XXI century molecular biology achievements made it possible to start personal tumor treatment based on its' specific genotype.