Association of patient tumour characteristics and 5-Year survival in women with breast cancer in Nigeria: A retrospective cohort study

Abstract

Objective: The sociodemographic and biological profiles of breast cancer differ globally, especially in women of African descent. In Nigeria, limited studies explore the impact of these breast cancer-related factors on survival. This study evaluated the association between patients' tumour characteristics and survival in breast cancer patients in three regional tertiary cancer treatment centres across Nigeria.

Methodology: Data were extracted from patients' case files with a histopathologic diagnosis of breast cancer from January 1, 2005, to January 1, 2019. Patients' sociodemographic and clinical features were presented, and survival probabilities were reported; the Log-rank test was used to determine the association between time to death and categorical variables.

Results: The study included 1020 patients across the three centres. The five-year survival probability was 0.65, and the 95% C.I. was 0.60- 0.69. Most patients were between the ages of 30 and 49, and 49% presented with left-sided breast cancer. Patients aged>70 had significantly better survival. Only 40% had Immunohistochemistry (IHC) done, out of which HR+ breast cancer accounted for 43%, while triple-negative breast cancer was 30%. Patients who received Herceptin and had molecular subtyping (immunohistochemistry) done had a higher survival probability.

Conclusions: Most breast cancer patients in Nigeria present at earlier ages with advanced disease, and the 5-year survival rates are lower than global rates. Only a few patients have access to optimal breast cancer management. There is an urgent need to provide equitable access to cancer treatment by scaling up the implementation of the strategic framework on breast cancer screening and management.