Survival Outcomes of Breast Cancer in Sudanese Women: A Hospital-Based Study

Abstract

Purpose: Breast cancer (BC) is the leading malignancy among Sudanese women. Yet, data on survival are limited. This study aimed to determine 5-year overall survival (OS) of BC in Sudanese women, and identify prognostic demographic and clinicopathologic factors.

Patients and methods: A hospital-based retrospective study was conducted by reviewing data of women with BC diagnosed and treated at the National Cancer Institute-University of Gezira during 2012, and followed up to end of August 2018. Data were retrieved from medical records and analyzed, OS was determined, and the prognostic factors were explored.

Results: A total of 225 cases were recruited. The median age at presentation was 45 years (range, 22-85 years). Clinical stage I, II, III, and IV represented 3.1%, 31.6%, 48%, and 17.3%, respectively. Most women (81.3%) were treated with curative intent. Of those, 25.1% received neoadjuvant chemotherapy. Mastectomy was the commonest (61.7%) type of surgery. The median follow-up period was 59.8 months with mean OS time of 55.7 months. The 5-year cumulative survival rate was 58%. The 5-year OS rates for stages I, II, III, and IV were 71.5%, 82.4%, 56.5%, and 8.4%, respectively. For lymph node (LN)-positive cases, 5-year OS rate was 63% and for LN-negative was 83.5%. Presenting with advanced-stage disease and positive LN status associated with short OS times (P < .005).

Conclusion: OS of women with BC in Central Sudan is worse than in the developed world, but similar to African countries. Our findings indicate that advanced stage at diagnosis and lymph nodal involvement are strong predictors of short survival times. Raising awareness and introducing early detection programs are critical for better survival of these patients.

FIG 1

Treatment modalities used in the management of patients with breast cancer. BCS, breast conserving surgery; CT, chemotherapy; HT, hormonal therapy; Mst, mastectomy; n, number of patients; NAC, neoadjuvant chemotherapy; RT, radiotherapy. ^aPatients might have received more than one treatment modality.

FIG 2

Overall survival (OS) of patients with breast cancer (N = 225). (A) Cumulative survival curve. (B) OS according to clinical stage (N = 225). (C) OS according to lymph node involvement (n = 186).