Factors Affecting Survival of Breast Cancer Patients After Diagnosis, Provincial Udonthani Hospital, Udonthani Province

Abstract

Background and rationale: Breast cancer is the most common and is the leading cause of death among women worldwide and also found the highest incidence of breast cancer between 2016 - 2018 in Thailand. The trend in incidence of breast cancer in Udonthani Province has been increasing. Today's breast cancer treatment has more diverse treatment methods. And there is a little  known about factors affecting survival of breast cancer patients. Especially in the northeastern region which has a large number of patients undergoing treatment.

            Objective: To study factors affecting, compare and survival rate of breast cancer patients treated at provincial Udonthani hospital, Mueang District, Udonthani Province.

            Methods: The retrospective cohort study was conducted. Data from the Udonthani Hospital Cancer Registry Database who were diagnosed between 1 January 2017 and 31 December 2021 and followed up on their vital status until 31 December 2023, totaling 1,263 breast cancer. Survival rates were analyzed using the Kaplan-Meier method. We reported the median survival time and 95% confidence intervals. To comparing between groups by Log-rank statistics test. To determine factors affecting by Cox regression which reported Adjusted Hazard ratio (Adjusted HR) with their 95% Confidence interval.

         Result: Of 1,263 breast cancer patients. There were 368 patients were death and corresponding the mortality rate was 8.18 per 100 person-years (95%CI: 7.38 - 9.06). The overall survival experience of 1-3-5 years after diagnosis were 88.99% (95%CI: 87.13 - 90.59), 74.17% (95%CI: 71.64 - 76.51) and 68.27% (95%CI: 65.34 - 71.01), respectively. After adjusting for the variables in the final model. We found that age, stage of disease and type of surgery are statistically associated to survival patient after diagnosis (p-value < 0.05). For patients age group 40-59 years and ≥ 60 years was the risk factor of mortality risk with a 0.6 (Adjusted HR = 0.6; 95%CI: 0.46 - 0.88) and 0.5 (Adjusted HR = 0.5; 95%CI: 0.39 - 0.78)-fold mortality risk compared to age group < 40 years respectively. Stage of disease, patients with stage 2, stage 3, and stage 4 was the risk factor of mortality risk with a 2.3 (Adjusted HR = 2.35; 95%CI: 1.12 - 4.94), 8.2 (Adjusted HR = 8.15; 95%CI:3.98 - 16.67) and 28.4 (Adjusted HR = 28.48; 95%CI:13.81 - 58.75)-fold mortality risk compared to stage 1, respectively. Type of surgery with modified radical mastectomy (MRM) was the risk factor of mortality risk with a 1.0 (Adjusted HR = 1.01; 95%CI: 1.01 - 1.02)-fold mortality risk compared to Breast-conserving therapy (BCT).

            Conclusion and recommendations: The current study demonstrates that age, stage of disease and type of surgery are associated to survival of breast cancer patients' after diagnosis. Therefore, physicians should emphasis those potential risk factors affecting to survival of breast cancer which leads to improved survival in women following the diagnosis of breast cancer.