Adult Health Nursing

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Browsing Adult Health Nursing by Subject "Breast cancer, predictors,survival"

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    Survival Status and Predictor of Mortality Among Breast Cancer Patients in Black Lion Specialized Hospital Adult Oncology Unit, Addis Ababa, Ethiopia, 2018.
    (Addis Ababa University, 2018-06) Shibabaw Wondimeneh; Mulugeta Tefera ( PHD)
    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 breast cancer patients is not estimated in our country. Hence, this study aimed to assess survival status and predictor of mortality among breast cancer patients in Black Lion Specialized Hospital. Objective: the main aim of the study is to assess the survival status and predictor of mortality among Breast Cancer patients in Black Lion Specialized Hospital Adult Oncology Unit in 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 regression were used at 5% level of significance to determine the net effect of each explanatory variable on time to death after diagnosis of breast cancer. Descriptive statistics were used to describe patient characteristics. Results: A total of 627 adult patients with breast cancer were included in the analysis. Of these, 169 patients (26.95%) were died giving a crude death rate of 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 26.42% (95% CI, 17.09 to 36.67 %) at 72 months of follow up. Independent predictors of mortality were clinical stage (III&IV),(HR =1.86 at 95% CI (1.13- 3.08)), positive lymph node status (HR: 1.83, 95% CI (1.22- 2.736)) and hormone therapy were protective (HR: 0.67, 95% CI (0.45- 0.98)). Conclusion and recommendation: The overall probability of survival in breast cancer patients were inferior when compared with those of high and middle income countries. Significant predictors of mortality in breast cancer patients were advanced clinical stage, poorly differentiated histology grade, surgical margin involvement, positive lymph node status, Absence of hormone therapy, and breast conserving surgery. Hence, a special emphasis should be given to early screening, early stage diagnosis & early initiation of treatment since advanced stage were prone to high mortality.