title: Hormone-receptor expression and survival patterns in operated cases of female invasive ductal breast carcinoma in Kerala: a retrospective cohort study.
abstract: BACKGROUND
  Though breast cancer is the most common cancer among women in Kerala, India, epidemiological data on breast cancer in the state is largely lacking. The objectives of this study were to analyze the survival pattern of female breast carcinoma in this region of the country and to compare the differences in survival with different hormone-receptor expressions.
  
  
  METHODS
  One hundred eighty-nine female breast cancer patients who were operated between 1 August 2008 and 3 July 2009 were followed up over telephone to obtain data on five-year survival. Grade, stage of the disease, and hormone-receptor (HR) status were obtained from treatment records. Logistic regression and the Kaplan-Meier survival analysis were used for statistical analysis.
  
  
  RESULTS
  The mean age of the study population was 49.07 (SD, 10.35) years. A majority of the patients had estrogen receptor (ER)+/progesterone receptor (PR)+tumors (n=103, 54.5%), followed by 72 (38.1%) ER-/PR-, 10 (5.3%) ER-/PR+, and 4 (2.1%) ER+/PR-. Stage of the disease, axillary nodal status, and hormone-receptor status showed statistically significant association with overall survival in breast cancer. Overall survival rate at the end of 5 years was 71.4%. Mortality was found to be highest for the ER-PR-group (47.2%).
  
  
  CONCLUSIONS
  Women in Kerala are diagnosed with breast carcinoma at a relatively younger age, yet the overall five-year survival for the disease is low when compared to developed nations. It is imperative that comprehensive breast cancer screening and treatment strategies be developed to enable earlier diagnosis and improve the survival of breast cancer in the state.
authors.affiliation: Department of General Surgery, Government Medical College, Thrissur, Kerala, 680596, India. ajitvl@gmail.com.
authors.forename: Ajith
authors.initials: A
authors.lastname: Vettuparambil
authors.affiliation: Department of General Surgery, Government Medical College, Thrissur, Kerala, 680596, India. ravimen@gmail.com.
authors.forename: Ravindran
authors.initials: R
authors.lastname: Chirukandath
authors.affiliation: Department of General Surgery, Government Medical College, Thrissur, Kerala, 680596, India. tbculas@gmail.com.
authors.forename: Terence B
authors.initials: TB
authors.lastname: Culas
authors.affiliation: Department of Community Medicine, Government Medical College, Thrissur, Kerala, 680596, India. mvsajna@yahoo.com.
authors.forename: Sajna Mathumkunnath
authors.initials: SM
authors.lastname: Vijayan
authors.affiliation: Government Medical College, Thrissur, Kerala, 680596, India. gautham1988@gmail.com.
authors.forename: Gautham
authors.initials: G
authors.lastname: Rajan
authors.affiliation: Department of Anatomy (Epidemiology), Government Medical College, Thrissur, Kerala, 680596, India. sathidevivk@gmail.com.
authors.forename: Sathidevi Vadakkepura
authors.initials: SV
authors.lastname: Kuttappan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone