A multi-institutional real world data study from India of 3453 non-metastatic breast cancer patients undergoing upfront surgery

Abstract

The present analysis reports the clinical, pathological, treatment profile and overall survival (OS) and disease-free survival (DFS) outcomes of consecutive breast cancer patients from three Indian centres, who underwent curative surgery as their first treatment. Among the 3453 patients, stage I, II, and III cases were 11.75%, 66.79%, and 21.64%, respectively while hormone receptor positive/ HER2 negative, triple negative (TNBC) and hormone receptor any/HER2 positive cases were 55.2%, 24.2% and 20.6%, respectively. The five-year OS in the entire cohort, node-negative and node-positive patients were 94.1% (93.25-94.98), 96.17% (95.2-97.15) and 91.83% (90.36-93.31), respectively, and the corresponding DFS were 88.1% (86.96-89.31), 92.0% (90.64-93.39) and 83.93% (82.03-85.89), respectively. The five-year OS in hormone receptor positive/HER2 negative, TNBC and HER2 subgroups were 96.11% (95.12-97.1), 92.74% (90.73-94.8) and 90.62% (88.17-93.15), respectively, and the corresponding DFS were 91.59% (90.19-93.02), 85.46% (82.79-88.22) and 81.29% (78.11-84.61), respectively. this is the largest dataset of early breast cancer patients from india with survival outcome analysis and can therefore serve as a benchmark for future studies. Breast cancer, an increasing public health dilemma, represents a heterogeneous group of diseases and still remains today the leading cancer in women and a major cause of morbidity and mortality worldwide 1. As per the GLOBOCAN 2018 statistics, there were a total of 1157294 new cancer cases in the year 2018 in both sexes across all ages in India. Among these, there were 162468 cases of breast cancer with a mortality of 87090 cases. The five-year prevalence across all age groups was 405456 cases 2. A high-incidence cancer of high-resource nations, breast cancer has swiftly become a global healthcare challenge. Improvements in screening, imaging, awareness and diagnostic strategies have led to improvement in the early detection of the disease. Owing to the advent of newer regimes and options, treatment stratification has greatly developed in the past decade 1. A multitude of therapeutic options have been developed and tested leading to major oncologic breakthroughs. Molecular based classifications and personalized treatment have also evolved in the past decade. This has also led to improvements in overall, progression-free and relapse-free survival 3,4. Nevertheless, a patient's survival is related to several prognostic factors, including number of positive lymph nodes, tumor size, hormone receptor status, histological type and grade, and patient's age 5. Although much has been reported by the Western world, it is imperative to have a large population-based data to study the disease

Prognostic Value of LRG1 in Breast Cancer: A Retrospective Study

“…A different molecular subtype was an independent predictive factor for DFS and OS in breast cancer. HER2-positive and triple-negative breast cancers have a poor prognosis compared to other groups (luminal A, luminal B) [16, 17]. In our study it was found that that the molecular subtype was an independent prognostic factor.…”

Ten-year survival outcome of breast cancer patients in India

“…As per the ICMR data based on cumulative analysis of data from 13 institutions across the country, the cumulative 5-year survival of a cohort of 7609 patients was 73.8%. [ 10 ] Subsequently, there have been a few more studies which have looked at 5-year OS,[ 9 ] which showed better survival, but no Indian data looked at 10-year survival outcome and more. Globally, also there have been only a small number of studies looking at more than 10-year survival outcome from a single hospital.…”

“…On literature search, we found a study from India with the largest dataset of breast cancer patients having median follow-up period not more than 6 years; still, around 14% of the total population had lost follow-up within 12 months of surgery. [ 9 ] Since we were looking to document survival statistics of all breast cancer patients treated with a curative intent, we have included patients with bone mets alone and also oligometastatic patients who had a complete response to chemotherapy. We have not included patients who have not taken adjuvant therapy or have gone for alternate medicines.…”

“…Available data from India are mainly on 5-year survival figures from some of the major cancer treatment centers. [ 8 9 10 ] Many patients are lost to follow-up after 5 years of primary treatment at oncology centers, even after the importance of follow-up visit is explained. [ 11 ]…”

Triple‐negative breast cancer and factors affecting disease‐free survival—Experience from a tertiary care center in India

“…This is in accordance with other studies. 9,10 We have also attempted to compare our findings with other studies from the Indian subcontinent which have examined TNBC. This is shown in Table 2.…”