Survival Outcomes in Breast Cancer Patients and Associated Factors in a Border Province of Thailand: A Hospital-based Review

Abstract

Objective: To evaluate the outcomes of breast cancer (BC) patients in Naradhiwas Rajanagarindra Hospital and factors associated with the outcomes. Material and Methods: A hospital-based retrospective review of patients who were diagnosed with BC in a tertiarylevel hospital in a Thailand border province was performed. Familial histories were obtained by telephone interviews. Results: There were 234 female patients diagnosed with BC during the 6-year study period. The mean age at diagnosis was 52.6 years. At presentation, 46.2% of the patients had locally advanced disease and 26.5% already had distant metastasis. Invasive ductal carcinoma (IDC) was the most common pathological subtype (84.6%) and 4.3% were ductal carcinoma in-situ. The five-year overall survival (OS) was 54% (95% confidence interval (CI) 40.25%-58.15%). On univariate analysis, factors associated with poorer survival were age >50 years, IDC pathology, T stage 3-4, N stage 2-3, distant metastasis, negative estrogen receptors, negative progesterone receptors, or both, positive human epidermal growth factor receptors 2, and Ki67 immunoreactivity >20%. Multivariate analysis showed that advanced T stage (adjusted HR1.97 95% CI 1.15-3.38), N stage (adjusted HR1.95 95% CI 1.05-3.64) and distant metastasis (HR1.86 95% CI 1.27- 2.71). Forty-nine percent of the BC women met the hereditary cancer criteria. Conclusion: The survival outcome of BC in Narathiwat province was poorer than that reported in other parts of the country. Delayed presentation might be an explanation for this disparity and a BC screening program is recommended to improve early detection.

Keywords

• breast cancer
• prognosis
• rural area
• survival outcome