Estimation of Progression Free Survival (PFS) in Patients with Hormone Positive Metastatic Breast Cancer in Cohort of Egyptian Patients (Retrospective Cohort Study)

Abstract

Background Breast cancer (BC) is the second most common cancer in the world and the most frequent cancer among women with approximately 1.7 million new cancer cases diagnosed yearly. It is the most common female malignancy accounting for 22.9% and 37.7% of all female cancers worldwide and in Egypt, respectively. BC in Egypt carries an unfavorable prognosis with 29% mortality and 3.7:1 incidence to mortality ratio. Aim of the Work to assess progression free survival (PFS) in patient with hormone positive metastatic breast cancer and prognostic factors affecting it in series of Egyptian patients treated in Ain Shams University hospitals and Maadi Medical Armed Forces Complex. Patients and Methods This retrospective cohort study was conducted in Clinical Oncology Department, Ain Shams University Hospitals and Medical Oncology Department, Maadi Medical Armed Forces Complex from January 2019 till December 2020. Progression free survival was estimated for all patients. Age of the studied patients ranged from 32 to 85 years with mean age of 58 years, 77.9% of the patients with MBC were postmenopausal, 22.9% of patients had positive family history. Most of our patients were IDC (95%) while only 5% were ILC, hormonal and molecular status among studied groups showed ER +ve in 100% of patients. Results Regarding to progesteron receptor (PR) status, 8.7% of patients were negative and 91.3% were positive. Ninety percent had HER2 overexpression. In 240 breast cancers, proliferative index Ki-67 was low in 84.6%. High levels were seen in 15.4% of cases. Progression free survival ranged from 1 to 66 months with median of 15 months. There are statistically significant relations of progression free survival with menopausal status, family history, HER2 overexpression, proliferative index Ki67, onset of metastasis evolution, site of metastasis, 1st line of treatment for metastasis, type of hormonal treatment for metastasis and ovarian ablation for premenopausal MBC patients. Conclusion There are statistically significant relations of PFS with 1st line of treatment of metastasis, as we find that Patients who received hormonal treatment only was significantly higher PFS (median PFS 17 months) compared to patients whose received both hormonal therapy and chemotherapy (median PFS 15 months) and patients whose received chemotherapy only (median PFS 5 months).