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. 2021 Jul;32(7):763-772.
doi: 10.1007/s10552-021-01427-z. Epub 2021 Apr 9.

Factors associated with breast cancer recurrence and survival at Sangre Grande Hospital, Trinidad

Kimberly Badal  1 , Rehanna Ali  2 , Wayne A Warner  3 , Akash Maniam  4 , Agatha Carrington  5 , Jerome E Foster  6 , Rajini Haraksingh  2
Affiliations

Factors associated with breast cancer recurrence and survival at Sangre Grande Hospital, Trinidad

Kimberly Badal et al. Cancer Causes Control. 2021 Jul.

Abstract

Purpose: The aim of this study is to determine the demographic, pathological, and treatment-related factors that predict recurrence and survival in a Trinidadian cohort of breast cancer patients.

Methods: The inclusion criteria for this study were female, over 18 years, and with a primary breast cancer diagnosis confirmed by a biopsy report occurring between 2010 and 2015 at Sangre Grande Hospital, Trinidad. Univariate associations with 5-year recurrence-free survival and 5-year overall survival were calculated using the Kaplan-Meier method for categorical variables and Cox Proportional Hazards for continuous variables. A multivariate model for prediction of recurrence and survival was determined using Cox regression.

Results: For the period 2010-2015, 202 records were abstracted. Five-year overall survival and recurrence-free survival rates were found to be 74.3% and 56.4%, respectively. Median times from first suspicious finding to date of biopsy report, date of surgery, and date of chemotherapy were 63 days, 125 days, and 189 days, respectively. In the univariate analysis, age (p = 0.038), stage (p < 0.001), recurrence (p = 0.035), surgery (p = 0.016), ER (p < 0.001) status, PR status (p < 0.001), and subtype (p < 0.001) were significantly associated with survival. Additionally, stage (p = 0.004), N score (p = 0.002), ER (p = 0.028) status, PR (p = 0.018) status, and subtype (p = 0.025) were significantly associated with recurrence. In the Cox multivariate model, Stage 4 was a significant predictor of survival (HR 6.77, 95% CI [0.09-2.49], p = 0.047) and N3 score was a significant predictor of recurrence (HR 4.47, 95% CI [1.29-15.54], p = 0.018).

Conclusion: This study reports a 5-year breast cancer survival rate of 74.3%, and a recurrence-free survival rate of 56.4% in Trinidad for the period 2010-2015.

Keywords: Breast cancer; Caribbean; Disparities; Outcomes; Trinidad and Tobago.

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