According to the National Cancer Institute, breast cancer is the most common cancer in women, following skin cancer. In 2003, there were an estimated 212,600 new cases of breast cancer in women, and every year, approximately 1,300 men are diagnosed as well. Special Topics first examined breast cancer research in 2001, and this month, we revisit the topic to see what advances are now being cited.

The top 20 breast cancer papers from the past decade are dominated by research related to the BRCA1 and BRCA2 cancer susceptibility genes. In fact, the #1 paper from the past decade, "A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1" (Miki, Y., et al., Science 266:66-71, 1994), has been cited over 600 times more than the next-ranked paper, and has given its authors a large boost in citations on our top 20 authors list. Other topics found in the top 20 breast cancer papers over the past decade include the use of tamoxifen in the NSABP trial and the use of raloxifene in the MORE trial; the risk of breast cancer with estrogens and progesterones; sentinel node biopsy vs. axillary dissection; lymphatic mapping; sentinel lymphadenectomy; and the use of postoperative radiotherapy in patients who have received adjuvant chemotherapy.

Over the past two years, the top 20 breast cancer papers reflect much of these same topics, but also contain the results of other major clinical trials, such as the Million Women Study and the Women’s Health Initiative. Studies on tamoxifen and raloxifene are joined by studies on letrozole (with or without tamoxifen), as well as paclitaxel and doxorubicin (given both singly and in conjunction). Other topics include tumorigenic breast cancer cells, metastasis to bone, and the role of gene expression in prediction of and response to breast cancer. The results of a 20-year follow-up study on mammography screening are also reported.

Methodology

To construct this database, papers were extracted based on title-supplied keywords for breast cancer. The keywords used were as follows: 

breast cancer*
 -or-
breast carcinoma*
 -or-
breast neoplasm*
 -or-
breast tumor*
 -or-
BRCA*

The baseline time span for this database is 1994-2004 (sixth bimonthly, an 11-year period). The resulting database contained 43,752 (10 years) and  9,175 (2 years) papers; 82,748 authors; 119 countries; 1,744 journals; and 13,911 institutions.

Rankings

Once the database was in place, it was used to generate the lists of top 20 papers (two- and ten-year periods), authors, journals, institutions, and nations, covering a time span of 1994-2004 (sixth bimonthly, an 11-year period).

The top 20 papers are ranked according to total cites. Rankings for author, journal, institution, and country are listed in three ways: according to total cites, total papers, and total cites/paper. The paper thresholds and corresponding percentages used to determine scientist, institution, country, and journal rankings according to total cites/paper, and total papers respectively are as follows:

Entity:	Scientists	Institutions	Countries	Journals
Thresholds:	25	103	15	35
Percentage:	1%	1%	50%	10%

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