Survival after treatment for American Joint Committee on Cancer Stage III breast cancer in Ahmadu Bello University Teaching Hospital Zaria
Main Article Content
Abstract
Background: Breast cancer is the most common malignancy in women worldwide. Patients with American Joint Committee on Cancer Stage III breast cancer have been noted to have good response to neoadjuvant chemotherapy. The aim of this study is to evaluate survival of such patients after treatment at our hospital.
Methods: A 5-year prospective study was conducted between January 2009 and December 2013. Patients had four courses of neoadjuvant chemotherapy (cyclophosphamide, adriamycin, paclitaxel), Auchincloss’ modified radical mastectomy, two courses of adjuvant chemotherapy and adjuvant tamoxifen (premenopausal) or letrozole (post-menopausal) for ER-positive tumours. All patients had radiotherapy. Follow-up was on outpatient basis and through phone calls. Statistical analysis was done using SPSS version 21.0, survival analyses with Kaplan–Meier method, multivariate analyses done with P ≤ 0.05 regarded as statistically significant.
Results: Data from 303 patients (291 females and 12 males) were analysed. One-year, 2-year, 3-year, 4-year and 5-year disease-free survival (DFS) was 79.80%, 56.57%, 51.51%, 47.47% and 47.47%, respectively. One-year, 2-year, 3-year, 4-year and 5-year overall survival (OS) was 80.80%, 61.61%, 55.56%, 51.51% and 51.50%, respectively. Initial tumour size, response to neoadjuvant chemotherapy, number of involved nodes, tumour grade and receptor status had statistically significant relationship with DFS and OS. The relationship between the patients’ age, gender and both DFS and OS was not statistically significant.
Conclusion: Five-year DFS and OS were 47.47% and 51.50%, respectively. Initial lesion size, response to therapy, involved nodes, tumour grade and receptor status had statistically significant relationship with DFS and OS.
Downloads
Article Details
The journal grants the right to make small numbers of printed copies for their personal non-commercial use under Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
References
1. Harford JB. Breast‑cancer early detection in low‑income and middle‑income countries: Do what you can versus one size fits all. Lancet Oncol 2011;12:306‑12.
2. Balabram D, Turra CM, Gobbi H. Survival of patients with operable breast cancer (Stages I‑III) at a Brazilian public hospital‑a closer look into cause‑specific mortality. BMC Cancer 2013;13:434.
3. Adetifa FA, Ojikutu RK. Prevalence and Trends in Breast Cancer in Lagos State, Nigeria. Afri Resear Rev 2009;3:1‑15.
4. Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R, Capocaccia R, et al. Cancer survival in five continents: A worldwide population‑based study (CONCORD). Lancet Oncol 2008;9:730‑56.
5. Salant T, Ganschow PS, Olopade OI, Lauderdale DS. “Why take it if you don’t have anything?” breast cancer risk perceptions and prevention choices at a public hospital. J Gen Intern Med 2006;21:779‑85.
6. Adebamowo CA, Ajayi OO. Breast cancer in Nigeria. West Afr J Med 2000;19:179‑91.
7. Saadatmand S, Bretveld R, Siesling S, Tilanus‑Linthorst MM. Influence of tumour stage at breast cancer detection on survival in modern times:
Population based study in 173, 797 patients. BMJ 2015;351:h4901.
8. Solanke TF, Adebamowo CA. Report of the State of the art in Oncology in Ibadan and Ife. National Headquarters of Cancer Registries in Nigeria. Ibadan: UCH; 1996.
9. Hoffman M, de Pinho H, Cooper D, Sayed R, Dent DM, Gudgeon A, et al. Breast cancer incidence and determinants of cancer stage in the
Western Cape. S Afr Med J 2000;90:1212‑6.
10. Yip CH, Taib NA. Challenges in the management of breast cancer in low‑ and middle‑income countries. Future Oncol 2012;8:1575‑83.
11. Gukas ID, Jennings BA, Mandong BM, Igun GO, Girling AC, ManassehAN, et al. Clinicopathological features and molecular markers of breast cancer in Jos, Nigeria. West Afr J Med 2005;24:209‑13.
12. Amir H, Kitinya JN, Parkin DM. A comparative study of carcinoma of the breast in an African population. East Afr Med J 1994;71:215‑8.
13. Gakwaya A, Kigula‑Mugambe JB, Kavuma A, Luwaga A, Fualal J, Jombwe J, et al. Cancer of the breast: 5‑year survival in a tertiary hospital in Uganda. Br J Cancer 2008;99:63‑7.
14. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC Cancer Staging Manual 7. New York: Springer; 2009. p. 648.
15. Brito C, Portela MC, Vasconcellos MT. Survival of breast cancer women in the state of Rio de Janeiro, Southeastern Brazil. Rev Saude Publica 2009;43:481‑9.
16. Yu XQ. Socioeconomic disparities in breast cancer survival: Relation to stage at diagnosis, treatment and race. BMC Cancer 2009;9:364.
17. Smith ER, Adams SA, Das IP, Bottai M, Fulton J, Hebert JR. Breast cancer survival among economically disadvantaged women: The influences of delayed diagnosis and treatment on mortality. Cancer Epidemiol Biomarkers Prev 2008;17:2882‑90.
18. van Herk‑Sukel MP, van de Poll‑Franse LV, Creemers GJ, LemmensVE, van der Linden PD, Herings RM, et al. Major changes in chemotherapy
regimens administered to breast cancer patients during 2000‑2008 in the Netherlands. Breast J 2013;19:394‑401.
19. Takahashi R, Toh U, Iwakuma N, Mishima M, Fujii T, Takenaka M, et al. Treatment outcome in patients with stage III breast cancer treated
with neoadjuvant chemotherapy. Exp Ther Med 2013;6:1089‑95.
20. Agbo PS, Khalid A, Oboirien M. Clinical presentation, prevalence and management of breast cancer in Sokoto, Nigeria. J Women’s Health
Care 2014;3:149‑57.
21. Kene TS, Odigie VI, Yusufu LM, Yusuf BO, Shehu SM, Kase JT. Pattern of presentation and survival of breast cancer in a teaching hospital in North Western Nigeria. Oman Med J 2010;25:104‑7.
22. Othieno‑Abinya NA, Nyabola LO, Abwao HO, Ndege P. Postsurgical management of patients with breast cancer at Kenyatta National
Hospital. East Afr Med J 2002;79:156‑62.
23. Amir H, KaayaEE, Kwesigabo G, Kiitinya JN. Breast cancer before and during the AIDS epidemic in women and men: A study of Tanzanian
Cancer Registry Data 1968 to 1996. J Natl Med Assoc 2000;92:301‑5.
24. Anyanwu SN. Temporal trends in breast cancer presentation in the third world. J Exp Clin Cancer Res 2008;27:17‑27.
25. Fregene A, Newman LA. Breast cancer in sub‑Saharan Africa: How does it relate to breast cancer in African‑American women? Cancer
2005;103:1540‑50.
26. Anele AA, Bowling M, Eckert GJ, Gonzalez E, Kipfer H, Sauder C. Treatment of breast cancer: IMO state Nigeria versus Indiana, USA women‑Comparative analytic study. J West Afr Coll Surg 2014;4:39‑69.
27. Okobia M, Bunker C, Zmuda J, Kammerer C, Vogel V, Uche E, et al. Case‑control study of risk factors for breast cancer in Nigerian women.
Int J Cancer 2006;119:2179‑85.
28. Son BH, Kwak BS, Kim JK, Kim HJ, Hong SJ, Lee JS, et al. Changing patterns in the clinical characteristics of Korean patients with breast
cancer during the last 15 years. Arch Surg 2006;141:155‑60.
29. Lee JH, Yim SH, Won YJ, Jung KW, Son BH, Lee HD, et al. Population‑based breast cancer statistics in Korea during 1993‑2002: Incidence, mortality, and survival. J Korean Med Sci 2007;22 Suppl: S11‑6.
30. Flores‑Luna L, Salazar‑Martínez E, Duarte‑Torres RM, Torres‑Mejía G, Alonso‑Ruiz P, Lazcano‑Ponce E. Prognostic factors related to breast
cancer survival. Salud Pública Mex 2008;50:119‑25.
31. Chávez‑MacGregor M, González‑Angulo AM. Breast cancer, neoadjuvant chemotherapy and residual disease. Clin Transl Oncol 2010;12:461‑7.
32. Ionta MT, Atzori F, Deidda MC, Pusceddu V, Palmeri S, Frau B, et al. Long‑term outcomes in stage IIIB breast cancer patients who achieved
less than a pathological complete responses (
33. da Rosa LM, Radünz V. Survival rates to woman with breast cancer: Review. Text Context Nurs Florianópolis 2012;21:980‑9.
34. Morse MA, Hobeika A, Osada T, Niedzwiecki D, Marcom PK, Blackwell KL, et al. Long term disease‑free survival and T cell and antibody responses in women with high‑risk Her2+breast cancer following vaccination against Her2. J Transl Med 2007;5:42.
35. Badve S, Turbin D, Thorat MA, Morimiya A, Nielsen TO, Perou CM, et al. FOXA1 expression in breast cancer—correlation with luminal
subtype A and survival. Clin Cancer Res 2007;13:4415‑21.
36. Schneider IJ, D’Orsi E. Five‑year survival and prognostic factors in women with breast cancer in Santa Catarina State, Brazil. Cad Saude
Publica 2009;25:1285‑96.
37. Fisch T, Pury P, Probst N, Bordoni A, Bouchardy C, Frick H, et al. Variation in survival after diagnosis of breast cancer in Switzerland.
Ann Oncol 2005;16:1882‑8.
38. Macià F, Porta M, Murta‑Nascimento C, Servitja S, Guxens M, Burón A, et al. Factors affecting 5‑ and 10‑year survival of women with breast
cancer: An analysis based on a public general hospital in Barcelona. Cancer Epidemiol 2012;36:554‑9.
39. Peto R. The worldwide overview: New results for systemic adjuvant therapies. Breast Cancer Res 2007;106:S5.