As in Europe, BC is the most common malignant tumor among women in Croatia, with a quarter of the newly diagnosed women with cancer, having BC . In 2016, among Croatian woman, 2735 new cases of BC were registered (126.6 per 100,000 people) with 990 death cases (45.8 per 100,000 people), making it the most common cause of death for women diagnosed with cancer in Croatia . A constant increase of the incidence of BC is evident, with 2303 cases of women in 2005 and 2748 cases of women in 2015. However, with the stabilization of the mortality trend in recent years, the number of cases in 2012 was 1033, whereas in 2016 dropped to 990 cases [1, 2, 3, 4]. Compared to other European countries, Croatia has medium-high incidence and high mortality from BC. Some progress has been made in the last 15 years regarding the treatment of BC and cancer survival rates in Croatia; however, the progress is still below the European average.
Since 2006, when the National Program of Breast Cancer Early Detection (Mamma) was first carried out in Croatia, the share of newly diagnosed BC in the localized stage among women (50–69 years old) is 60–70%, whereas prior to the start of Mamma, it was 40%. The positive effect of the implementation of the screening program of BC is also evident in the 2017 data, showing a 15–20% reduction in the mortality rate from BC. A significant achievement has been seen in the last two years: there was a decrease in mortality from BC in all age groups, with the largest decline in the older age groups, 70 years and above.
According to the results of CONCORD-3 study, which analyzed individual records of 37.5 million patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries, Croatia is in the lower half of the European rankings for BC 5-year survival (79%) . In comparison, according to EUROCARE-5 study, 5-year BC survival for women diagnosed between 2000 and 2007 in Croatia was 76.3%, while the average of European countries was 81.8% . According to aforementioned data, over the last 15 years there has been progress in terms of cancer survival in Croatia however, there is still room for improvement.
In contrast, data in relation to situation with BC in Kosovo are limited. The data from the Kosovo Agency of Statistics-health statistics, shows a steady increase of new BC cases by each subsequent year. During the period of 2012 to 2018 there has been a continuous increase in the number of new cases ranging from 207, in the year 2012 to 444 new cases in the year 2018. Notably, in 2019 there were 376 new registered cases (20.9 per 100000 people). These figures in Kosovo can be attributed to the worldwide increase of incidence as well as improved reporting, better means of detection and diagnosis and the increased awareness of the population. In addition, the implementation of the mobile mammography program, established in 2014, has played a role in terms of the reach out of patients living in remote areas. According to the Kosovar data, only about 40–50% of cases are diagnosed in the early stages of the disease, regardless of age. However, data on survival and mortality rates of BC patients in Kosovo are not available.
The aim of this study was to evaluate clinical and histological characteristics of patients’ cohorts who underwent primary surgical treatment due to BC in two university hospitals, one in Zagreb, Croatia and the other in Prishtina, Kosovo in order to compare disease stage at the time of diagnosis, in country with implemented mammografical screening with country without it.