An additional limitation is that few of these studies have considered the extent to which breast cancer mortality has changed over the past few decades for women with early invasive breast cancer or the way in which it varies with time since diagnosis.
The National Cancer Registration and Analysis Service , together with its preceding organisations, has registered all patients with a diagnosis of cancer in England for many decades.These registrations are routinely linked with other information at the level of the patient. For this study, all women registered in England during January 1993 to December 2015 with breast cancer as their first invasive cancer were identified and their data were de-personalised before release for analysis.
Data were collated and checked before analysis; see supplementary text S1 and figure S1 for details. We received data on a total of 783 980 women . We excluded women if they were aged <18 or ≥90 years at diagnosis , their registrations were based on a death certificate only or they had less than three months of follow-up , or their histology was not invasive breast cancer .
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