Abstract

Introduction: Breast cancer is a leading cause of death worldwide, and ranks as the fifth cause of death from all cancers, and the most common cause of cancer death in women in both developing and developed countries. Breast cancer ranks as the first most frequent cancer among women in Ethiopia. In spite of the high incidence and mortality rate, survival status among patients with breast cancer were not determined in Ethiopia.

Objective: this study aimed to assess survival status and predictor of mortality among breast cancer patients at Black Lion Specialized Hospital,Addis Ababa, Ethiopia 2018.

Methods: An institution based retrospective longitudinal study was conducted in BLSH Adult Oncology Unit. All cases of breast cancer registered from January1st 2012-December30th, 2014 in BLSH were followed retrospectively for the six-year survival (until december30th, 2017). Kaplan-meier survival curve together with log rank test were used to test for the presence of difference in survival among predictor variables. Cox proportional hazard model was used at 5% level of significance to determine the net effect of each explanatory variable on time to death after diagnosis of breast cancer. Furthermore, aassumptions was check by schoenfeld residual test.

Results: In this study incidence of mortality was 9.8 per 100 person years (95% CI: 8.49- 11.47).The overall median survival time was 56.5(95% CI (53.46 - 60.83)) months. The overall estimated survival rate after diagnosis of breast cancer was nearly 27% (95% CI, 17.09 to 36.67 %) at 72 months of follow up. The overall survival rates at 1, 3, and 5 years were, 97.2%, 80.8%, and 46.2% respectively. Predictors of mortality were clinical stage (III&IV),(AHR =1.86) , poorly differentiated histology (AHR: 3.1) & positive lymph node status (AHR:3.13).Whereas hormone therapy (AHR: 0.67),& chemotherapy (AHR:0.72) were protective.

Conclusion:  The overall probability of survival was inferior when compared with those high and middle income countries. Predictors of mortality were advanced clinical stage, poorly differentiated histology and positive lymph node status. In contrast hormone therapy, modified radical mastectomy and chemotherapy were reduced hazard of mortality. A special emphasis could be given to early screening; stage diagnosis & initiation of treatment.

Keywords: Breast cancer, predictors, survival, Ethiopia