Christina Mirjam Weiner1, Assefa Mathewos2, Adamu Addissie3, Wondimu Ayele3, Abraha Aynalem2, Tigeneh Wondemagegnehu2, Andreas Wienke4, Ahmedin Jemal5, Peter Zerche6, Christoph Thomssen7, Andreas Seidler8, Eva Johanna Kantelhardt9. 1. Department of Gynaecology and Obstetrics, St. Joseph Hospital, Dresden, Germany. Electronic address: weiner@josephstift-dresden.de. 2. Radiotherapy Centre, Addis Ababa University, Addis Ababa, Ethiopia. 3. School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia. 4. Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany. 5. Surveillance and Health Services Research, American Cancer Society, Atlanta, USA. 6. Department of Surgery, Hospital Martha-Maria Halle-Dölau, Halle, Saale, Germany. 7. Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany. 8. Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany. 9. Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany; Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany.
Abstract
OBJECTIVES: There is little information on characteristics, treatment and outcome of metastatic breast cancer (mBC) patients in low-income countries. This study aims to describe mBC in the setting of Ethiopia. MATERIALS AND METHODS: A retrospective cohort study was conducted among all female mBC patients from the only oncologic hospital in Addis Ababa 01/2006 to 12/2010. Time between first metastasis and known death or loss to follow-up for more than six months as surrogate for death were used for Cox proportional hazards model. RESULTS: A total of 573 patients were included; 188 (32.8%) women with de novo mBC (dnmBC) and 385 women with recurrent mBC (rmBC). The average age at time of first metastasis was 43.7 (standard deviation 11.9) years with an average survival probability of twelve months. Negative hormone receptor status, only present in 29% (Hazard ratio HR = 2.28 [95% confidence interval CI 1.56-3.32] p < 0.001), and grade 3 (HR = 1.72 [95% CI 1.15-2.55] p = 0.008) had significant influence on survival. Patients with initial bone metastasis (HR = 0.63 [95% CI 0.48-0.83] p = 0.001) had best chances of survival compared to more common initial visceral metastasis. About 35% of the patients received chemotherapy and 30.5% were on endocrine therapy. CONCLUSION: The lower survival for mBC in Addis Ababa compared to that from Western countries is presumably due to the later presentation at the hospital and lack of standard therapy. An unexpected high proportion of patients with hormone receptor positive mBC encourage consequent utilization of endocrine therapy to improve the quality of palliative care in this cohort.
OBJECTIVES: There is little information on characteristics, treatment and outcome of metastatic breast cancer (mBC) patients in low-income countries. This study aims to describe mBC in the setting of Ethiopia. MATERIALS AND METHODS: A retrospective cohort study was conducted among all female mBC patients from the only oncologic hospital in Addis Ababa 01/2006 to 12/2010. Time between first metastasis and known death or loss to follow-up for more than six months as surrogate for death were used for Cox proportional hazards model. RESULTS: A total of 573 patients were included; 188 (32.8%) women with de novo mBC (dnmBC) and 385 women with recurrent mBC (rmBC). The average age at time of first metastasis was 43.7 (standard deviation 11.9) years with an average survival probability of twelve months. Negative hormone receptor status, only present in 29% (Hazard ratio HR = 2.28 [95% confidence interval CI 1.56-3.32] p < 0.001), and grade 3 (HR = 1.72 [95% CI 1.15-2.55] p = 0.008) had significant influence on survival. Patients with initial bone metastasis (HR = 0.63 [95% CI 0.48-0.83] p = 0.001) had best chances of survival compared to more common initial visceral metastasis. About 35% of the patients received chemotherapy and 30.5% were on endocrine therapy. CONCLUSION: The lower survival for mBC in Addis Ababa compared to that from Western countries is presumably due to the later presentation at the hospital and lack of standard therapy. An unexpected high proportion of patients with hormone receptor positive mBC encourage consequent utilization of endocrine therapy to improve the quality of palliative care in this cohort.
Authors: Alyssa D Schwartz; Afua Adusei; Solomon Tsegaye; Christopher A Moskaluk; Sallie S Schneider; Manu O Platt; Daniel Seifu; Shelly R Peyton; Courtney C Babbitt Journal: Ann Biomed Eng Date: 2021-06-17 Impact factor: 3.934
Authors: Zerko Wako; Daniel Mengistu; Negalign Getahun Dinegde; Tseganesh Asefa; Mulugeta Wassie Journal: Breast Cancer (Dove Med Press) Date: 2021-06-09
Authors: Yoanna S Pumpalova; Oluwatosin A Ayeni; Wenlong Carl Chen; Daniel S O'Neil; Sarah Nietz; Boitumelo Phakathi; Ines Buccimazza; Sharon Čačala; Laura W Stopforth; Hayley A Farrow; Maureen Joffe; Witness Mapanga; Judith S Jacobson; Katherine D Crew; Herbert Cubasch; Paul Ruff; Alfred I Neugut Journal: Breast Cancer Res Treat Date: 2021-06-14 Impact factor: 4.624