Survival status and prognostic factors among breast cancer women at selected hospitals in southern Ethiopia, 2023.
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Date
2023
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Addis Ababa University
Abstract
Introduction: Breast cancer is the major cause of morbidity and mortality worldwide,
particularly in countries with limited resources. Patients in developing countries,
particularly Ethiopia, are less likely to survive due to delayed diagnosis and advanced-
stage presentations. Several studies have been conducted on the prognostic factors among
breast cancer patients in Ethiopia, but they cannot consider neutrophils to lymphocytes as
the prognostic factor.
Objective: To assess the survival status and prognostic factors among Breast Cancer
womenat selected hospitals in southern Ethiopia,2023.
Methods: A retrospective cohort studywas conducted among 507 randomly selected
breast cancer women in selected hospitals in southern Ethiopia.Two trained BSc nurses
collected the data using an open data kit (ODK).Descriptive statistics were summarized
using tables and graphs. The bivariable and multivariable Weibull regression modelswere
used to identify the prognostic factors. The final model fitness was investigated using the
Cox-Snail residual test, and the Schoenfeld residuals test was used to examine the
proportional hazards assumption.
Results:The overall survival of breast cancer women at the end of two and three years was
54.5% and 23.9%, respectively. An excellent and good Nottingham prognostic score
(AHR: 0.26, 95% CI: 0.12, 0.53) and (AHR: 0.39, 95% CI: 0.18, 0.81), chemotherapy
(AHR: 0.59, 95% CI: 0.36, 40.93), metastasis (AHR: 1.89, 95% CI: 1.31, 2.74), advanced
stages (AHR: 1.73, 95% CI: 1.19, 2.51), hormone therapy (AHR: 0.64, 95% CI: 0.44,
0.92), and lower neutrophil to lymphocyte ratio (AHR: 0.68; 95% CI: 0.47; 0.97) were the
prognostic factors of breast cancer women.
Conclusion: This study revealed that the breast cancer survivorship rate was lower than
that of an earlier study from Ethiopia. An increased ratio of neutrophils to lymphocytes at
the time of diagnosis and a poor NPI were linked to a worse chance of survival for breast
cancer women; this indicated that promoting early diagnosis of breast cancer and
treatment could be important to improve the survival of breast cancer patients.
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Keywords
Breast cancer, survival, prognostic factors