Breast cancer in Tripoli/Libya: 1990-2008.

Abstract

e12052 Background: Breast cancer is the most frequently diagnosed cancer among women and second most frequent cause of cancer death. This study aims to to study epidemiology and biology of breast cancer in Tripoli over the past 19 years and to study survival and disease-free survival among these patients. Methods: Nonrandomized retrospective study in patients with breast cancer confirmed by biopsy, in onclogy clinic in central hospital and Tripoli Medical Center. 1,494 patients were included in this study in the period between Jan 1990till June 2008. Results: The age ranged between 20-70 years (mean 46.6 +12.6SD), median 46.5 years. 1.3% were male. 56.4% were premenopausal. 12.4% have positve family history of breast cancer. In years between 1990-1999, 39.5% of cases were stage I and II and 48.8% III and IV respectively, and in years between 2000 and 2008 48.5% were stage I and II and 41.5% III and IV respectively. 60% have involved lymph nodes. 87% of cancers were invasive duct carcinoma, 4.75% were invasive lobular carcinoma and 8.25% other histopathology. Hormone receptor status was studied after 2003 by immunohistochemistry, 54.3% were positive for estrogen receptors. 24% has HER2 overexpression. Most patients were treated by mastectomy (80%). Chemotherapy alone or chemotherapy with radiotherapy was given as adjuvant treatment. in years between 1990-1999, only 60% received anthracyclines based chemotherapy while in years 2000-2008, 87.6% received anthracycline based cheomtherapy. Tamoxifen was given to all patients who had positive receptors status or unknown status. During follow-up, out of 1,295 women on tamoxifen, 5 patients developed endometrial carcinoma. Regarding overall recurrence and survival rate, 5-year survival rate of patients diagnosed between 1990-1999 was 45.6% and disease-free survival was 37%. 5-year survival rate of patients diagnosed between 2000-2008 was 60.6% and disease-free survival was 50.3%. Conclusions: In the last 9 years, patients were diagnosed at earlier stages and better stratification of patients through the determination of hormone receptors and Neu status and the introduction of anthracyclines have contributed to better survival. No significant financial relationships to disclose.