Data Analysis of Survival Outcome of Breast Cancer Patients at Department of Oncology Faculty of Medicine Ain Shams Uni-versity, Retrospective Study

Abstract

Background: Breast cancer is the most common cancer among females world-wide, and the second most common cause of cancer related death after lung cancer, which makes its global burden substantial. However, the burden is not evenly distributed worldwide: with large variations between different countries, regions, and within specific regions. Objectives: Assessment of disease free survival and oval all survival of BC patients in relation to treatment received in each group of BC molecular sub-types at department of oncology faculty of medicine Ain Shams University. Patients and Methods: this is A retrospective study done on BC patients presented to department of oncology, Ain shams university from 2010 to 2012. All patients diagnosed with BC since 2010 to 2012 were included and were divided into Lu-minal A, Luminal B, HER 2 overexpression and basal like (triple negative) groups according to biological profile and were also categorized into stages,0,I,II,III and IV according to TN M staging of BC (AJCC Cancer Staging Manual, 2017).. Collected data correlated the treatment strategy which was used in each group of patients to the DFS. Results: Breast cancer patients who diagnosed in this period and still on follow up till October 2018 were 249 patients. All of them were females with median age of 49. Postmenopausal patients were 50.6%. 95.2% patients had loco-regional disease at time of diagnosis while 4.8% patients diagnosed with de no-vo metastasis. Overall, 23.69% of patients died, 24.9% of patients relapsed, while, 51.41% of patients had disease free survival 6 years. Median DFS and OS of patients with localized disease reached 6 years. In de novo metastatic cases median PFS after first line of treatment reached 1 year and median OS was 3 years. Luminal A, B, Triple negative, HER2neu over-expression and un-known patients represented 65.46%, 7.63%, 19.28%, 5.62% and 2.01% respec-tively with median DFS 7, 6, 5.5, 4 and 4 years respectively with significant P value (<0.001) and median OS 7, 6, 6, 5 and 5.2 years respectively with signifi-cant p value (0.008). Most of cases with loco-regional disease were diagnosed at early stages I & II (55.4%) while stage IV disease represented only 4.82%. Stage 0 and IA reached 7 years median DFS, stages IB, IIA, IIB and IIIA pa-tients reached 6 years median DFS, while stages IIIB and IIIC patients reached 5 years median DFS, with statistically significant P value (P=0.004). as regard OS stage 0 and IA patients reached 7 years median OS while Stage IB, IIA, IIB, IIIA, IIIB, IIIC patients reached 6 years median OS and stage IIIC reached 5.5years median OS with statistically significant P value (P=0.043). As regard hormonal treatment in premenopausal patients, 37% of patients received Ta-moxifen for 5 years, 25% of patients didn’t receive hormonal treatment, 18.97% of patients received switch protocol, 7.76% of patients received Tamoxifen less than 2 years, 6.9% of patients received extended protocol and 4.31% of patients received aromatase inhibitor (4.31%). While in postmenopausal patients, there were 41.32% of patients received switch protocol, 25.25.62% of patients did not receive hormonal treatment, 16.53% of patients received Tamoxifen for 5 years, 9.92% of patients received Aromatase inhibitors, 6.61% of patients received Tamoxifen less than 2 years with significant P value of DFS and OS (P<0.001) for both. Conclusion: Using a case-case analysis to assess the associations between sur-vival outcome and BC molecular subtypes (luminal A, luminal B, Her2-overexpressing, and triple negative), we observed significant Correlation with tumor subtype. These associations by subtype showed further support to the growing evidence base that BC Represent different biological subtypes with distinct etiologic pathways and prognoses.