Introduction: Breast cancer is one of the leading causes of death worldwide. We
carried out this study with the aim of evaluating the determinants of early
survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and
prospective data collection of breast cancer patients during 6 years in two Hospitals
of Yaoundé from January 2017 to December 2022. We consulted the files in search
of epidemiological, clinical, paraclinical, therapeutic and survival variables.
We completed the survival data directly from the patients or their relatives
after their consent. We analyzed the data using SPSS version 23.0 software.
Survival analysis was done using the Kaplan-Meier method and survival curves
were compared using the Log Rank test. Factors influencing survival were
evaluated using the Cox model. The significance threshold (P value) was set at
0.05 at 95% confidence interval. The study was approved by the ethics
committees. Results: We included 500 patients
whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61
years. The most represented age group was 30 to 45 years old (45.8%). Less than
half(41.6%) were postmenopausal. The most frequent
reason for consultation was a breast lump (79.9%). The most common clinical
stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was
the most represented histological type (84.7%). The most represented
histological grade was grade 2 (40.2%). Immunohistochemistry was performed in
34.20% of cases. The most represented molecular subtype was triple negative
(41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not
receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy,
and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3,
4 and 5 years was respectively 90.6%; 83.1%; 74.2%; 69.8% and 59.2%. The median
survival
References
[1]
Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. https://doi.org/10.3322/caac.21660
[2]
Momenimovahed, Z. and Salehiniya, H. (2019) Epidemiological Characteristics of and Risk Factors for Breast Cancer in the World. Breast Cancer: Targets and Therapy, 11, 151-164. https://doi.org/10.2147/BCTT.S176070
[3]
Pilleron, S., Sarfati, D., Janssen-Heijnen, M., Vignat, J., Ferlay, J., Bray, F., et al. (2019) Global Cancer Incidence in Older Adults, 2012 and 2035: A Population-Based Study. International Journal of Cancer, 144, 49-58.
https://doi.org/10.1002/ijc.31664
[4]
Ferlay, J., Shin, H.-R., Bray, F., Forman, D., Mathers, C. and Parkin, D.M. (2010) Estimates of Worldwide Burden of Cancer in 2008: GLOBOCAN 2008. International Journal of Cancer, 127, 2893-2917. https://doi.org/10.1002/ijc.25516
[5]
Sankaranarayanan, R., Swaminathan, R., Jayant, K. and Brenner, H. (2011) An Overview of Cancer Survival in Africa, Asia, the Caribbean and Central America: The Case for Investment in Cancer Health Services. IARC Scientific Publications, 162, 257-291.
[6]
Daly, B. and Olopade, O.I. (2015) A Perfect Storm: How Tumor Biology, Genomics, and Health Care Delivery Patterns Collide to Create a Racial Survival Disparity in Breast Cancer and Proposed Interventions for Change: Closing the Racial Disparity Gap in Breast Cancer. CA: A Cancer Journal for Clinicians, 65, 221-238.
https://doi.org/10.3322/caac.21271
[7]
Ndoua, C.C.N., Motolouze, K., Etienne, A., Ntsama, J.A.M., Rs, T.N., Tatsipie, W.L., et al. (2022) Survival of Patients Operated on for Breast Cancer in Yaounde: A Study of 166 Cases. Health Sciences and Disease, 23, 27-30.
https://www.hsd-fmsb.org/index.php/hsd/article/view/3871
[8]
Mapoko, B.S.E., Okobalemba, E.A., Mbassi, E.D.B., Sango, A.J.F., Mapenya, R.R.M., Mayeh, A.M.M., et al. (2023) Déterminants de la survie prolongée après diagnostic de cancer du sein à l′Hôpital Général de Yaoundé. Pan African Medical Journal, 44, Article No. 1. https://www.panafrican-med-journal.com/content/article/44/1/full
[9]
Ngowa, J.D.K., Kabeyene, A., Ngarvounsia, R., Atenguena, E., Tchawe, Y.S.N., Ngassam, A., et al. (2020) Consultation, Diagnosis and Treatment Delays for Breast Cancer among Patients Followed up at the Yaoundé General Hospital, Cameroon. Open Journal of Obstetrics and Gynecology, 10, 1580-1589.
[10]
Motolouze, K., Ndoua, C.C.N., Okobalemba, E.A., Njassine, R.S.T., Mapoko, B.S.E., Fosso, L.C.F., et al. (2023) Profil clinique, paraclinique et thérapeutique des patientes opérées du cancer du sein à l′Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY). Pan African Medical Journal, 44, Article No. 2.
https://www.panafrican-med-journal.com/content/article/44/2/full
[11]
Diallo, M., Fall, D., Mballo, I., Niang, C.I. and Charfi, M.E. (2022) Coûts médicaux directs de traitement du cancer du sein à l’Institut Joliot Curie de l’Hôpital Aristide Le Dantec de Dakar, Sénégal. Pan African Medical Journal, 42, Article 266.
[12]
Cubasch, H., Dickens, C., Joffe, M., Duarte, R., Murugan, N., Tsai Chih, M., et al. (2018) Breast Cancer Survival in Soweto, Johannesburg, South Africa: A Receptor-Defined Cohort of Women Diagnosed from 2009 to 11. Cancer Epidemiology, 52, 120-127. https://doi.org/10.1016/j.canep.2017.12.007
[13]
Morra, A., Jung, A.Y., Behrens, S., Keeman, R., Ahearn, T.U., Anton-Culver, H., et al. (2021) Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium. Cancer Epidemiology, Biomarkers & Prevention, 30, 623-642.
https://doi.org/10.1158/1055-9965.EPI-20-0924
[14]
Essiben, F., Foumane, P., Meka, E., Tchakounté, M., Julius Sama, D., Nsahlai, C., et al. (2017) Descriptive Analysis of 192 Cases of Breast Cancer Occurring before Age 40 in Yaounde, Cameroon. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6, 2704-2710.
https://doi.org/10.18203/2320-1770.ijrcog20172898
[15]
Ogundiran, T.O., Ayandipo, O.O., Ademola, A.F. and Adebamowo, C.A. (2013) Mastectomy for Management of Breast Cancer in Ibadan, Nigeria. BMC Surgery, 13, Article No. 59. https://doi.org/10.1186/1471-2482-13-59
[16]
Madyaningtias, E.P., Sampepajung, D., Prihantono, P. and Faruk, M. (2021) Epidemiological and Clinicopathological Characteristics of Breast Cancer in Eastern Indonesia. Journal of Medical & Allied Sciences, 11, 27-32.
https://doi.org/10.5455/jmas.97327
[17]
Kemfang Ngowa, J.D., Yomi, J., Kasia, J.M., Mawamba, Y., Ekortarh, A.C. and Vlastos, G. (2011) Breast Cancer Profile in a Group of Patients Followed up at the Radiation Therapy Unit of the Yaounde General Hospital, Cameroon. Obstetrics and Gynecology International, 2011, Article ID: 143506.
https://doi.org/10.1155/2011/143506
[18]
Ranaivomanana, M., Hasiniatsy, N.R.E., Rakotomahenina, H. and Rafaramino, F. (2021) Aspects épidémio-cliniques des cancers du sein au Service d′Oncologie de Fianarantsoa, Madagascar de 2011 à 2018. Pan African Medical Journal, 38, Article 264. https://doi.org/10.11604/pamj.2021.38.264.20031
[19]
Fouhi, M.E., Benider, A., Gaëtan, K.Z.A. and Mesfioui, A. (2020) Profil épidémiologique et anatomopathologique du cancer de sein au CHU Ibn Rochd, Casablanca. Pan African Medical Journal, 37, Article No. 41.
https://doi.org/10.11604/pamj.2020.37.41.21336
[20]
Togo, A., Traoré, A., Traoré, C., Dembélé, B.T., Kanté, L., Diakité, I., et al. (2010) Cancer du sein dans deux centres hospitaliers de Bamako (Mali): Aspects diagnostiques et thérapeutiques. Journal Africain du Cancer/African Journal of Cancer, 2, 88-91. https://doi.org/10.1007/s12558-010-0060-x
[21]
Reynoso-Noverón, N., Villarreal-Garza, C., Soto-Perez-De-Celis, E., Arce-Salinas, C., Matus-Santos, J., Ramírez-Ugalde, M.T., et al. (2017) Clinical and Epidemiological Profile of Breast Cancer in Mexico: Results of the Seguro Popular. Journal of Global Oncology, 3, 757-764. https://doi.org/10.1200/JGO.2016.007377
[22]
Galukande, M., Wabinga, H. and Mirembe, F. (2015) Breast Cancer Survival Experiences at a Tertiary Hospital in Sub-Saharan Africa: A Cohort Study. World Journal of Surgical Oncology, 13, Article No. 220.
https://doi.org/10.1186/s12957-015-0632-4
[23]
Balawardena, J., Skandarajah, T., Rathnayake, W. and Joseph, N. (2020) Breast Cancer Survival in Sri Lanka. JCO Glob Oncology, 6, 589-599.
https://doi.org/10.1200/JGO.20.00003
[24]
Gnangnon, F., Gbessi, D., Kiki-Migan, Y., Attolou, S., Imorou Souaibou, Y., Denakpo, J., et al. (2021) étude de la survie et des facteurs pronostiques du cancer du sein chez la femme dans deux hôpitaux de référence au Sud du Bénin. Revue d’épidémiologie et de Santé Publique, 69, S69-S70.
https://doi.org/10.1016/j.respe.2021.04.119
[25]
Mahjoub, N., Kamel, B.S., Mokrani, A., Mansouri, H., Achour, L., Chraiet, N., et al. (2021) Profil épidémiologique et anatomopathologique du cancer du sein dans la région du Nord-Ouest de la Tunisie. La Tunisie Medicale, 99, 441-448.
[26]
Atangana, P.J., Nguefack, C.T., Fotsing, C.T., Bell, E.D., Tayou, R., Tomfeu, C.N., et al. (2017) Aspects Immunohistochimiques des Cancers du Sein à Douala et à Yaounde. Health Sciences and Diseases, 18, 14-20.
https://www.hsd-fmsb.org/index.php/hsd/article/view/859
[27]
Kantelhardt, E.J., Zerche, P., Mathewos, A., Trocchi, P., Addissie, A., Aynalem, A., et al. (2014) Breast Cancer Survival in Ethiopia: A Cohort Study of 1,070 Women. International Journal of Cancer, 135, 702-709. https://doi.org/10.1002/ijc.28691
[28]
Colzani, E., Liljegren, A., Johansson, A.L.V., Adolfsson, J., Hellborg, H., Hall, P.F.L., et al. (2011) Prognosis of Patients with Breast Cancer: Causes of Death and Effects of Time since Diagnosis, Age, and Tumor Characteristics. Journal of Clinical Oncology, 29, 4014-4021. https://doi.org/10.1200/JCO.2010.32.6462
[29]
Sankaranarayanan, R. (2011) Cancer Survival in Africa, Asia, the Caribbean and Central America. Introduction. IARC Scientific Publications, 162, 1-5.
[30]
Cowppli-Bony, A., Colonna, M., Ligier, K., Jooste, V., Defossez, G., Monnereau, A., et al. (2019) [Descriptive Epidemiology of Cancer in Metropolitan France: Incidence, Survival and Prevalence]. Bulletin du Cancer, 106, 617-634.
https://doi.org/10.1016/j.bulcan.2018.11.016
[31]
Haroon, S., Hashmi, A.A., Khurshid, A., Kanpurwala, M.A., Mujtuba, S., Malik, B., et al. (2013) Ki67 Index in Breast Cancer: Correlation with Other Prognostic Markers and Potential in Pakistani Patients. Asian Pacific Journal of Cancer Prevention, 14, 4353-4358. https://doi.org/10.7314/APJCP.2013.14.7.4353
