Survival analysis of 1148 women diagnosed with breast cancer in Southern Iran

Abstract

BackgroundWhile there has been much research regarding risk factors and prognostic factors for breast cancer in general, research specific to Iran is sparse. Further, the association between breast cancer survival and socio-demographic and pathologic factors has been widely studied but the majority of these studies are from developed countries. Southern Iran has a population of approximately 4 million. To date, no research has been performed to determine breast cancer survival and to explore the association between the survival and socio-demographic and pathologic factors in Southern Iran, where this study was conducted.MethodsThe data were obtained from the cancer registry in Fars province, Southern Iran and included 1148 women diagnosed with breast cancer between 2000 and 2005. The association between survival, and sociodemographic and pathological factors, distant metastasis at diagnosis, and treatment options was investigated using Cox regression.ResultsThe majority of patients were diagnosed with an advanced tumour size. Five-year overall survival was 58% (95%CI; 53%–62%). Cox regression showed that family income (good vs poor: hazard ratio 0.46, 95%CI; 0.23–0.90) smoking (HR = 1.40, 95%CI; 1.07–1.86), metastases to bone (HR = 2.25, 95%CI; 1.43–3.52) and lung (HR = 3.21, 95%CI;1.70–6.05), tumour size (≤ 2 cm vs ≥ 5 cm: HR = 2.07, 95%CI;1.39–3.09) and grade (poorly vs well differentiated HR = 2.33, 95%CI; 1.52–3.37), lymph node ratio (0 vs 1: HR = 15.31, 95%CI; 8.89–26.33) and number of involved node (1 vs >15: HR = 14.98, 95%CI; 8.83–25.33) were significantly related to survival.ConclusionThis is the first study to evaluate breast cancer survival in Southern Iran and has used a wide range of explanatory factors, 44. The results demonstrate that survival is relatively poor and is associated with diagnosis with late stage disease. We hypothesise that this is due to low level of awareness, lack of screening programs and subsequent late access to treatment.

Who are the Breast Cancer Survivors in Malaysia?

“…Another important prognostic factor of breast cancer survival is the involvement of lymph nodes and its extension. As in many other studies, the survival rate was worst as the number of lymph nodes increased (Gebauer, 2002;Banarjee, 2003;Rezaianzadeh et al, 2009).…”

Social Support and its Predictors Among Iranian Cancer Survivors

“…Cancer survivors estimated to be 28.8 million in 2008 (Bray et al, 2013). Similarly, the survival rate in Iranian cancer patients has risen noticeably in recent years (Rezaianzadeh et al, 2009). Based on the wide literature review, there is no published evidence about the prevalence of Iranian cancer survivors.…”

Survival analysis of breast cancer patients with different chronic diseases through parametric and semi-parametric approaches

“…Some studies emphasized on the factors such as hormone therapy (hormone receptor) [9,12,16,20,22,23,25,27,33,35,36,38], Her2 [9,11], grade [9,11,13,19,21,24,31,34,37,38], and lymph node involvement [11,19,20,21,23,38,39]; however, others did not propose hormone therapy as a factor [10]. The proportion of lymph nodes [12,24] and education [12] have also been studied in some models. Surgery [14,15,25,29,36] and CA 15-3 marker [15] are the other factors that can be considered in the survival analysis.…”

“…Surgery [14,15,25,29,36] and CA 15-3 marker [15] are the other factors that can be considered in the survival analysis. Furthermore, the combination of the following factors have been suggested across different studies: familial history [24], smoking [24], affected side [20,39], place of residence [29], number of involved lymph nodes [22,24,27,31,34,35,37], stage [5,6,8,17,25,26,42], stage of surgery [25], tumor size [16, 19, 20-24, 27, 28, 31, 34, 35, 37, 38, 41], complete clinical and pathological response [41], medicine [29], type of pathology [32], type of treatment [17,21], chemotherapy [25,33,36,37], neoadjuvant chemotherapy [18], radiotherapy [25,33,36], number of metastasis [30], bone pain [30], and time interval leading to bone metastasis [42]. No study has considered chronic diseases as an effective factor of survival analysis.…”

“…They identified 39 models for the survival analysis, determining risk factors for breast cancer. Metastasis [4,6,14,16,28,42], background of benign tumors [4], and age at diagnosis [4,5,16,INTRODUCTION 22,23,24,25,26,28,29,[32][33][34][35][36][37]39] were considered as the main factors in the survival analysis. Some studies emphasized on the factors such as hormone therapy (hormone receptor) [9,12,16,20,22,23,25,27,33,35,36,38], Her2 [9,11], grade [9,11,13,19,21,24,31,34,37,38], and lymph node involvement …”