Survival Rate and Prognostic Factors among Iranian Breast Cancer Patients
-
Mojtaba MESHKAT
,
Ahmad Reza BAGHESTANI
,
Farid ZAYERI
,
Maryam KHAYAMZADEH
,
Mohammad Esmaeil AKBARI
Abstract
Background: Survival time is one of the indicators used for evaluation of the quality of care in different types of malignancies, including breast cancer. The present study aimed to estimate the survival rate of breast cancer and its related factors among Iranian patients.
Methods: Overall, 3148 cases of breast cancer who referred to the Cancer Research Center in Shahid Beheshti University of Medical Sciences, Tehran, Iran during 1994-2017 participated in this longitudinal study. Survival estimates were calculated using the Kaplan-Meier method and the Bayesian generalized Birnbaum–Saunders model with cure rate from geometric distribution. Clinical, pathological, and biological variables as potential prognostic factors were entered in univariate and multivariate analyses.
In order to identify the significant prognostic factors, 95% highest posterior density (HPD) intervals were used.
Results: The overall 1, 5, 10, 15, 20 and 25-year survival rate were 95%, 75%, 60%, 47%, 46% and 46%, respectively. A significant relation was observed between survival time and the variables such as age, size of tumor, number of lymph nodes, stage, histological grade, estrogen receptor, progesterone receptor, and lymphovascular invasion.
Conclusion: The findings of this study might help the health managers to plan long-term programs considering regional determinants, public education, and screening for early detection of breast cancer cases which can eventually influence the overall survival rate of these patients.
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34. Yoshida M, Shimizu C, Fukutomi T et al (2011). Prognostic factors in young Japanese women with breast cancer: prognostic value of age at diagnosis. Jpn J Clin Oncol,41(2):180-9.
35. Mahmood H, Faheem M, Mahmood S, Sadiq M, Irfan J (2015). Impact of age, tumor size, lymph node metastasis, stage, receptor status and menopausal status on overall survival of breast cancer patients in Pakistan. Asian Pac J Cancer Prev,16(3):1019-24.
36. Chen X, Cong Y, Pan L et al (2014). Luminal (Her2 negative) prognostic index and survival of breast cancer patients. Cancer Epidemiol,38(3):286-90.
37. Orang E, Marzony ET, Afsharfard A (2013). Predictive role of tumor size in breast cancer with axillary lymph node involvement-can size of primary tumor be used to omit an unnecessary axillary lymph node dissection? Asian Pac J Cancer Prev,14(2):717-22.
38. Peng R, Wang S, Shi Y et al (2011). Patients 35 years old or younger with operable breast cancer are more at risk for relapse and survival: a retrospective matched case–control study. Breast, 20(6):568-73.
39. Habibi G, Leung S, Law JH et al (2008). Redefining prognostic factors for breast cancer: YB-1 is a stronger predictor of relapse and disease-specific survival than estrogen receptor or HER-2 across all tumor subtypes. Breast Cancer Res,10(5):R86.
40. Niwińska A, Murawska M, Pogoda K (2010). Breast cancer brain metastases: differences in survival depending on biological subtype, RPA RTOG prognostic class and systemic treatment after whole-brain radiotherapy (WBRT). Ann Oncol, 21(5):942-8.
41. Brogi E, Murphy C, Johnson M et al (2011). Breast carcinoma with brain metastases: clinical analysis and immunoprofile on tissue microarrays. Ann Oncol, 22(12):2597-603.
2. Rosai J, Ackerman LV (2011). Rosai and Ackerman's surgical pathology. 10th ed. New York: Edinburgh,Mosby.
3. Kumar V, Abbas AK, Aster JC, Robbins SL (2013). Robbins basic pathology. 10th ed. Philadelphia, PA: Elsevier/Saunders.
4. The Global Cancer Observatory (GCO) (2012). http://globocan.iarc.fr/old/FactSheets/cancers/breast-new.asp
5. Siegel RL, Miller KD, Jemal A (2016). Cancer statistics, 2016. CA Cancer J Clin, 66(1):7-30.
6. Kasper DL, Fauci AS, Stephen H et al (2016). Harrison's Principles of Internal Medicine. 19th ed: McGraw-Hill.
7. Acil H, Cavdar I (2014). Comparison of quality of life of Turkish breast cancer patients receiving breast conserving surgery or modified radical mastectomy. Asian Pac J Cancer Prev,15(13):5377-81.
8. Rahimzadeh M, Pourhoseingholi MA, Kavehie B (2016). Survival Rates for Breast Cancer in Iranian Patients: a Meta-Analysis. Asian Pac J Cancer Prev,17(4):2223-7.
9. Roshandel G, Ghanbari-Motlagh A, Partovipour E et al (2019). Cancer incidence in Iran in 2014: Results of the Iranian National Population-based Cancer Registry. Cancer Epidemiol, 61:50-58.
10. Baghestani AR, Moghaddam SS, Majd HA et al (2015). Survival Analysis of Patients with Breast Cancer using Weibull Parametric Model. Asian Pac J Cancer Prev, 16(18):8567-71.
11. Khodabakhshi R, Gohari M, Moghadamifard Z et al (2011). Disease-Free Survival of Breast Cancer Patients and Identification of Related Factors. Razi J Med Sci,18(89):27-33.
12. Movahedi M, Haghighat S, Khayamzadeh M et al. (2012). Survival rate of breast cancer based on geographical variation in Iran, a national study. Iran Red Crescent Med J,14(12):798-804.
13. Janbabai G, Moosazadeh M, Farshidi F et al (2016). Survival Rate of Breast Cancer in Iran: A Meta-Analysis. Asian Pac J Cancer Prev,17(10):4615-21.
14. Hunk KK, Robertson JFR, Bland KI (2015). The Breast. In: F.Charles B, editor. Schwartzs Principles of surgery. 10th ed. Texas: McGraw-Hill. p. 517-20.
15. Andersen SW, Newcomb PA, Hampton J et al (2011). Reproductive factors and histologic subtype in relation to mortality after a breast cancer diagnosis. Breast Cancer Res Treat,130(3):975-80.
16. Newton PK, Mason J, Venkatappa N et al (2015). Spatiotemporal progression of metastatic breast cancer: a Markov chain model highlighting the role of early metastatic sites. NPJ Breast Cancer, 1:15018.
17. Mirzaei H, Sabahat A, Nasrollahi F, Mohammadi Yeganeh L (2010). Correlation between ER, PR, HER2 receptors and prognostic factors in breast cancer. Pejouhandeh,15(4):152-6.
18. Lan N, Laohasiriwong W, Stewart J (2013). Survival probability and prognostic factors for breast cancer patients in Vietnam. Glob Health Action, 6:1-9.
19. Kleinbaum DG, Klein M (2012). Survival Analysis: A Self-Learning Text. 3rd ed. New York: Springer.
20. Yu H-F, Peng C-Y (2013). Estimation for Weibull distribution with type II highly censored data. Qual Technol Quant M,10(2):193-202.
21. Ibrahim J, Chen M, Sinha D (2001). Bayesian survival analysis: New York, NY: Springer.
22. Wienke A (2010). Frailty models in survival analysis: CRC Press.
23. Maller RA, Zhou X (1996). Survival analysis with long-term survivors: John Wiley & Sons.
24. Corbière F, Commenges D, Taylor JM, Joly P (2009). A penalized likelihood approach for mixture cure models. Stat Med, 28(3):510-24.
25. Volodin I, Dzhungurova O (2000). On limit distributions emerging in the generalized Birnbaum-Saunders model. J Math Sci, 99(3):1348-66.
26. Leiva V (2015). The Birnbaum-Saunders Distribution: Academic Press.
27. Elsayed E (2013). Accelerated Life Testing Model for a Generalized Birnbaum-Saunders Distribution. QUALITA2013.
28. Meshkat M, Baghestani AR, Zayeri F (2018). The Poisson Generalized Birnbaum-Saunders Cure Model and Application in Breast Cancer Data. J Biom Biostat, 9:389.
29. Van Belle G, Fisher LD, Heagerty PJ, Lumley T (2004). Biostatistics: a methodology for the health sciences: John Wiley & Sons.
30. Akbari ME, Khayamzadeh M, Khoshnevis S et al (2012). Five and ten years survival in breast cancer patients mastectomies vs. breast conserving surgeries personal experience. Iranian Journal of Cancer Prevention,1(2):53-6.
31. Baghestani AR, Zayeri F, Akbari ME et al (2015). Fitting Cure Rate Model to Breast Cancer Data of Cancer Research Center. Asian Pac J Cancer Prev,16(17):7923-7.
32. (ASCO) tASoCO. Breast Cancer: Statistics 2016 [Available from: http://www.cancer.net/cancer-types/breast-cancer/statistics
33. Shahidsales S, Hosseini S, Ahmadi Simab S et al (2014). The importance of Prognostic factors (ER, PR, P53) in breast cancer and their relationship with stage of disease. Medical Journal of Mashhad University of Medical Sciences, 57(2):457-63.
34. Yoshida M, Shimizu C, Fukutomi T et al (2011). Prognostic factors in young Japanese women with breast cancer: prognostic value of age at diagnosis. Jpn J Clin Oncol,41(2):180-9.
35. Mahmood H, Faheem M, Mahmood S, Sadiq M, Irfan J (2015). Impact of age, tumor size, lymph node metastasis, stage, receptor status and menopausal status on overall survival of breast cancer patients in Pakistan. Asian Pac J Cancer Prev,16(3):1019-24.
36. Chen X, Cong Y, Pan L et al (2014). Luminal (Her2 negative) prognostic index and survival of breast cancer patients. Cancer Epidemiol,38(3):286-90.
37. Orang E, Marzony ET, Afsharfard A (2013). Predictive role of tumor size in breast cancer with axillary lymph node involvement-can size of primary tumor be used to omit an unnecessary axillary lymph node dissection? Asian Pac J Cancer Prev,14(2):717-22.
38. Peng R, Wang S, Shi Y et al (2011). Patients 35 years old or younger with operable breast cancer are more at risk for relapse and survival: a retrospective matched case–control study. Breast, 20(6):568-73.
39. Habibi G, Leung S, Law JH et al (2008). Redefining prognostic factors for breast cancer: YB-1 is a stronger predictor of relapse and disease-specific survival than estrogen receptor or HER-2 across all tumor subtypes. Breast Cancer Res,10(5):R86.
40. Niwińska A, Murawska M, Pogoda K (2010). Breast cancer brain metastases: differences in survival depending on biological subtype, RPA RTOG prognostic class and systemic treatment after whole-brain radiotherapy (WBRT). Ann Oncol, 21(5):942-8.
41. Brogi E, Murphy C, Johnson M et al (2011). Breast carcinoma with brain metastases: clinical analysis and immunoprofile on tissue microarrays. Ann Oncol, 22(12):2597-603.
| Files | ||
| Issue | Vol 49 No 2 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v49i2.3102 | |
| Keywords | ||
| Cure fraction models; Breast cancer; Survival probability | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
MESHKAT M, BAGHESTANI AR, ZAYERI F, KHAYAMZADEH M, AKBARI ME. Survival Rate and Prognostic Factors among Iranian Breast Cancer Patients. Iran J Public Health. 2020;49(2):341-350.
