Clinicopathological Factors Affecting Breast Cancer Survival in Jamaican Women: A Retrospective Review.

Abstract

Breast cancer is the leading cause of cancer affecting women worldwide. The survival rate is primarily affected by the stage of the disease and several other demographic and clinicopathological factors. This study is a retrospective cohort study of female patients of the University Hospital of the West Indies diagnosed with breast cancer between 2011 and 2016. The age, tumor size, SBR/Nottingham grade, tumor histologic subtype, tumor molecular subtype, and survival status of the cohort on November 1, 2019, were determined. The data were summarized. Survival across each variable was compared using univariate log-rank tests, Cox proportional hazard models, and crude and adjusted models. A second wave analysis was performed excluding patients whose survival status was presumed. A total of 503 patients were analyzed. The overall survival rate at 1, 3, and 5years were 96.4%, 84.9%, and 79.0%, respectively, for the entire cohort. The molecular subtype was the most significant clinicopathological factor affecting overall survival. A younger age < 40years, higher histologic grade, estrogen receptor-negative breast cancers, invasive ductal type breast cancers, and T1 lesions were associated with poorer survival outcomes at 5years. The findings were reproduced after a second wave analysis excluding patients who were presumed alive was applied. Breast cancer overall survival in Jamaica is consistent with that of other developing countries in the literature. This study is an important contribution to the growing body of literature available and aids to the overall understanding of the behavior of breast cancer locally.