Author(s)

Um Esther Meka Ngo^1,2*, Junie Annick Metogo Ntsama^1,3, Kodoumé Motolouze¹, Naomi Marie Laurene Ndtoungou Schouame¹, Obalemba Etienne Atenguena^1,4, Claude Cyrille Noa Ndoua^1,3, Robinson Enow Mbu^1,2

¹Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Yaoundé, Cameroon.
²Yaoundé Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon.
³Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction, Yaoundé, Cameroon.
⁴Yaoundé General Hospital, Yaoundé, Cameroon.

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 was not reached; however, the first quartile (Q1) was 36 months (3 years). Independent factors associated with reduced survival were breast ulceration (aHR = 3.23; p = 0.002), bilateral tumor location (aHR = 9.2; p < 0.001) and clinical stage 3 (aHR = 1.72; p = 0.010) while patients classified ACR3 on imaging (aHR = 0.19; p = 0.005) had improved survival. Conclusion: Breast cancer survival from 1 to 5 years decrease from 90 to 59%. Mortality was highest in the first 40 months. Independent factors associated with reduced survival were breast ulceration, bilateral tumor location and clinical stage 3 while patients classified ACR3 on imaging had improved survival.

Determinants, Early Survival, Breast Cancer, Yaoundé

Ngo, U. , Ntsama, J. , Motolouze, K. , Schouame, N. , Atenguena, O. , Ndoua, C. and Mbu, R. (2024) Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon. Open Journal of Obstetrics and Gynecology, 14, 487-501. doi: 10.4236/ojog.2024.143042.