Survival status and predictors of mortality among Breast Cancer patients in Adult Oncology Unit at Black Lion Specialized Hospital, Addis Ababa, Ethiopia, 2018

Abstract

Abstract Introduction Breast cancer is a foremost cause of death worldwide, ranks fifth among causes of death from all types of cancers; this is the most common cause of cancer death in women among both developing and developed countries. Breast cancer ranks first among most frequent cancers in women of Ethiopia. In spite of the high incidence, mortality rate, and survival status among breast cancer patients was not determined in Ethiopia. Objective The main aim of the study is to assess the survival status and predictor the mortality among Breast Cancer patients in Adult Oncology Unit at Black Lion Specialized Hospital in 2018. Methods An institution based retrospective follow up study was conducted in Adult Oncology Unit at Black Lion Specialized Hospital. All cases of breast cancer registered from 1 st January 2012 to 31 th December,2014 were followed for the six-year survival (until 31 th December, 2017). Kaplan-Meier survival curve together with log rank test was deployed to test for variations in the survival among predictor variables. Cox regression was used at 5% level of significance to determine the net effect of each independent variable on time to death of breast cancer clients. Results The results indicate that the incidence rate 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 was recorded 27% (95% CI, 17.09 to 36.67 %) at 72 months of follow up, whereas at odd years (1, 3, and 5 years) were, 97.2%, 80.8%, and 46.2% respectively. Predictors of mortality were assessed at clinical stage (III&IV),(AHR =1.86), poorly differentiated histology (AHR: 3.1) & positive lymph node status (AHR:3.13),Whereas adjuvant hormone therapy (AHR: 0.67) and chemotherapy (AHR:0.72) were protective. Conclusion The overall probability of survival in Ethiopia was inferior when compared with other high and middle-income countries. Predictors of mortality were at advanced clinical stage, poorly differentiated histology grade, surgical margin involvement and positive lymph node status. In contrary, adjuvant hormone therapy, modified radical mastectomy and chemotherapy were protective factors. Hence, special emphasis could be given to early screening, stage diagnosis and initiation of treatment.