Background and Objectives: Breast cancer survival is sparingly addressed in India due to inadequate follow-up, lack of organized screening activities and an incomplete system of death registration. This study analyses the specific factors affecting breast cancer survival in a tertiary care hospital. Methods: This was a five year retrospective analysis of a cohort of breast cancer patients who attended a tertiary care hospital in Southern India. Case records of 112 women fulfilling the inclusion criteria were reviewed. SES (socioeconomic status), age at menarche, family history of breast cancer, disease staging by TNM (Tumour Node Metastasis) criteria and treatment modality were some of the variables considered for estimating the hazard ratio using the Cox regression analysis. Survival probability was analysed using the Kaplan-Meier and forward Wald cox regression. Results: Women in the study were predominantly (68%) from the lower socio economic strata with more than half (57%) being less than 50 years of age. Seventy two percent of them presented with a local extension of the disease while 13% had evidence of distant metastasis. Overall mean survival rate was noted to be 53.7 months (95% CI 51.6, 55.9). Stage at diagnosis (distant metastasis) (RR 5.11, 95% CI 1.599 – 16.334, p < 0.05) and age at menarche (< 14years) (RR 2.866, 95% CI (1.175 – 6.990), p < 0.05) were found to have a significant impact on the outcome. The reported death rate among the study population was 27.7%. Conclusion: This study shows a promising overall 5 year disease survival where stage at diagnosis was found to be an important predictor. Increasing awareness about early detection coupled with an organised screening programme that coordinates with existing treatment facilities could go a long way in improving the mortality burden due to breast cancer in the country.
Nair Suma, Atreya R Mihir, Kathrikolly Thejas, Kamath Asha, Mamidipudi S Vidyasagar