TITLE:
Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon
AUTHORS:
Um Esther Meka Ngo, Junie Annick Metogo Ntsama, Kodoumé Motolouze, Naomi Marie Laurene Ndtoungou Schouame, Obalemba Etienne Atenguena, Claude Cyrille Noa Ndoua, Robinson Enow Mbu
KEYWORDS:
Determinants, Early Survival, Breast Cancer, Yaoundé
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.14 No.3,
March
29,
2024
ABSTRACT: Introduction: Breast cancer is one of the leading causes of death worldwide. We
carried out this study with the aim of evaluating the determinants of early
survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and
prospective data collection of breast cancer patients during 6 years in two Hospitals
of Yaoundé from January 2017 to December 2022. We consulted the files in search
of epidemiological, clinical, paraclinical, therapeutic and survival variables.
We completed the survival data directly from the patients or their relatives
after their consent. We analyzed the data using SPSS version 23.0 software.
Survival analysis was done using the Kaplan-Meier method and survival curves
were compared using the Log Rank test. Factors influencing survival were
evaluated using the Cox model. The significance threshold (P value) was set at
0.05 at 95% confidence interval. The study was approved by the ethics
committees. Results: We included 500 patients
whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61
years. The most represented age group was 30 to 45 years old (45.8%). Less than
half (41.6%) were postmenopausal. The most frequent
reason for consultation was a breast lump (79.9%). The most common clinical
stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was
the most represented histological type (84.7%). The most represented
histological grade was grade 2 (40.2%). Immunohistochemistry was performed in
34.20% of cases. The most represented molecular subtype was triple negative
(41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not
receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy,
and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3,
4 and 5 years was respectively 90.6%; 83.1%; 74.2%; 69.8% and 59.2%. The median
survival was not reached; however, the first quartile (Q1) was 36 months (3 years). Independent factors associated
with reduced survival were breast ulceration (aHR = 3.23; p = 0.002), bilateral
tumor location (aHR = 9.2; p Conclusion: Breast
cancer survival from 1 to 5 years decrease from 90 to 59%. Mortality was
highest in the first 40 months. Independent factors associated with reduced
survival were breast ulceration, bilateral tumor location and clinical stage 3
while patients classified ACR3 on imaging had improved survival.