Breast cancer incidence and mortality are rising being the second prevalent cancer type and the fourth-ranked deadly cancer.1 Till the end of 2020 there were a total of 7.8 million breast cancer cases worldwide.2 Although the prevalence is the highest in developed nations breast cancer-related death is greater in developing countries2 with the highest burden in Sub-Saharan Africa.3 In Kenya it is the third deadly cancer next to esophageal and cervical cancer which accounted for 9.9 of cancer death.14 In addition breast cancer is associated with a considerable economic impact5 and poor quality of life.6
Despite breast cancer treatment outcomes being relatively poor or heterogeneous among breast cancer patients there was a paucity of data in the African settings especially in Kenya. Hence this study aimed to determine treatment outcomes among breast cancer patients at Kitui Referral Hospital.
A hospital-based retrospective cohort study design was conducted among adult patients with breast cancer. All eligible breast cancer patients undergoing treatment from January 2015 to June 2020 in the study setting were included. Hence a total of 116 breast cancer patients medical records were involved in the study. Patients medical records were retrospectively reviewed using a predesigned data abstraction tool. The data were entered cleaned and analyzed using SPSS Statistical Package for Social Sciences version 26 software. Descriptive analysissuch as percentage frequency mean and figureswas used to present the data. KaplanMeier survival analysis was used to estimate the mean survival estimate across different variables. A Cox regression analysis was employed to determine factors associated with mortality
The study showed that the overall survival and mortality rate was 62.9 73 and 37.1 43 respectively. The regression analysis showed that patients who had an advanced stage of disease had a 3.82 times risk of dying crude hazard ratio 3.82 95 confidence interval 1.59.8 than an early stage of the disease. Besides patients with distant metastasis had 4.4 times more hazards of dying than crude hazard ratio 4.4 95 confidence interval 2.19.4 their counterparts.
More than half of breast cancer patients survived after 5 years of the initial diagnosis and more than one-third have died. Most patients were diagnosed with invasive ductal breast and had stage III breast cancer during the initial diagnosis. Relatively more number of patients had estrogen receptor-positive progesterone receptor-negative and HER2 negative breast cancer types. In addition the mean cancer-specific survival time and mean cancer-specific survival time after metastasis was 25 23.6 and 5.6 months respectively. Furthermore the tumor size was the only statistically significant predictor of mortality among breast cancer patients in the multivariate Cox regression analysis as it is seen from the study that most of the patients had poor prognoses.