Abstract
Introduction Breast cancer is a leading cause of death worldwide, and ranks as the fifth cause of death from all cancers, and the most common cause of cancer death in women in both developing and developed countries. Breast cancer ranks as the first most frequent cancer among women in Ethiopia. In spite of the high incidence and mortality rate, survival status among breast cancer patients was not determined in our country. Hence, this study aimed to assess survival status and predictor of mortality among breast cancer patients in Black Lion Specialized Hospital.
Objective the main aim of the study is to assess the survival status and predictor of mortality among Breast Cancer patients in Black Lion Specialized Hospital Adult Oncology Unit in 2018.
Methods An institution based retrospective longitudinal study was conducted in BLSH Adult Oncology Unit. All cases of breast cancer registered from January 1st 2012-December 30th, 2014 in BLSH were followed retrospectively for the six-year survival (until december30th, 2017). Kaplan-meier survival curve together with log rank test were used to test for the presence of difference in survival among predictor variables. Cox regression were used at 5% level of significance to determine the net effect of each explanatory variable on time to death after diagnosis of breast cancer.
Results In this study incidence of mortality was 9.8 per 100 person years (95% CI: 8.49-11.47). The overall median survival time was 56.5(95% CI (53.46 - 60.83)) months. The overall estimated survival rate after diagnosis of breast cancer was nearly 27% (95% CI, 17.09 to 36.67 %) at 72 months of follow up. The overall survival rates at 1, 3, and 5 years were, 97.2%, 80.8%, and 46.2% respectively. Predictors of mortality were clinical stage (III&IV), (AHR =1.86), poorly differentiated histology (AHR: 3.1) & positive lymph node status (AHR:3.13). Whereas hormone therapy (AHR: 0.67), & chemotherapy (AHR:0.72) were protective.
Conclusion The overall probability of survival was inferior when compared with those of high and middle-income countries. Significant predictors of mortality were advanced clinical stage, poorly differentiated histology grade, surgical margin involvement, positive lymph node status, Absence of hormone therapy, and breast conserving surgery. A special emphasis could be given to early screening; stage diagnosis & initiation of treatment.
Abbreviations
- AAU
- Addis Ababa University
- AJCC
- American joint committee on cancer
- BLSH
- black lion specialized hospital
- ER
- estrogen receptor
- EFMOH
- Ethiopian federal ministry of health
- GLOBOCAN
- global burden of cancer
- HER2
- Human epidermal growth factor receptor 2
- HIC
- high income country
- IDC
- invasive ductal carcinoma
- LMICs
- low and middle income countries
- PR
- progesterone receptor
- SSA
- sub-Saharan Africa.