title: Breast cancer survival in Ethiopia: a cohort study of 1,070 women.
abstract: There is little information on breast cancer (BC) survival in Ethiopia and other parts of sub-Saharan Africa. Our study estimated cumulative probabilities of distant metastasis-free survival (MFS) in patients at Addis Ababa (AA) University Radiotherapy Center, the only public oncologic institution in Ethiopia. We analyzed 1,070 females with BC stage 1-3 seen in 2005-2010. Patients underwent regular follow-up; estrogen receptor-positive and -unknown patients received free endocrine treatment (an independent project funded by AstraZeneca Ltd. and facilitated by the Axios Foundation). The primary endpoint was distant metastasis. Sensitivity analysis (worst-case scenario) assumed that patients with incomplete follow-up had events 3 months after the last appointment. The median age was 43.0 (20-88) years. The median tumor size was 4.96 cm [standard deviation (SD) 2.81 cm; n = 709 information available]. Stages 1, 2 and 3 represented 4, 25 and 71%, respectively (n = 644). Ductal carcinoma predominated (79.2%, n = 1,070) as well as grade 2 tumors (57%, n = 509). Median follow-up was 23.1 (0-65.6) months, during which 285 women developed metastases. MFS after 2 years was 74% (69-79%), declining to 59% (53-64%) in the worst-case scenario. Patients with early stage (1-2) showed better MFS than patients with stage 3 (85 and 66%, respectively). The 5-year MFS was 72% for stages 1 and 2 and 33% for stage 3. We present a first overview on MFS in a large cohort of female BC patients (1,070 patients) from sub-Saharan Africa. Young age and advanced stage were associated with poor outcome.
authors.affiliation: Department of Gynaecology, Martin Luther University, Halle an der Saale, Germany; Institute of Clinical Epidemiology, Martin Luther University, Halle an der Saale, Germany.
authors.forename: E J
authors.initials: EJ
authors.lastname: Kantelhardt
authors.forename: P
authors.initials: P
authors.lastname: Zerche
authors.forename: A
authors.initials: A
authors.lastname: Mathewos
authors.forename: P
authors.initials: P
authors.lastname: Trocchi
authors.forename: A
authors.initials: A
authors.lastname: Addissie
authors.forename: A
authors.initials: A
authors.lastname: Aynalem
authors.forename: T
authors.initials: T
authors.lastname: Wondemagegnehu
authors.forename: T
authors.initials: T
authors.lastname: Ersumo
authors.forename: A
authors.initials: A
authors.lastname: Reeler
authors.forename: B
authors.initials: B
authors.lastname: Yonas
authors.forename: M
authors.initials: M
authors.lastname: Tinsae
authors.forename: T
authors.initials: T
authors.lastname: Gemechu
authors.forename: A
authors.initials: A
authors.lastname: Jemal
authors.forename: C
authors.initials: C
authors.lastname: Thomssen
authors.forename: A
authors.initials: A
authors.lastname: Stang
authors.forename: S
authors.initials: S
authors.lastname: Bogale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018275:Carcinoma, Lobular / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult
keywords: Africa; Ethiopia; breast neoplasms; prognosis; survival