Survival Rate of Breast Cancer and Related Factors in Iran: A 27-Year Follow-Up

Mohammad  Esmaeil Akbari; Atieh  Akbari; Mohammad  Akbari; Maryam  Khayamzadeh

doi:10.18502/ijph.v54i4.18426

Mohammad Esmaeil Akbari Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Atieh Akbari Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohammad Akbari Department of Health Economics, Faculty of Management and Economics, Tarbiat Modarres University, Tehran, Iran
Maryam Khayamzadeh Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v54i4.18426

Keywords: Breast neoplasm; Disease management; Epidemiology; Survival; Iran

Abstract

Background: Several factors can affect the survival of patients with breast cancer (BC). We estimated BC patients' 5-, 10-, and 15-year survival rates and influential factors in a single medical center during the last three decades.

Methods: We enrolled patients diagnosed with BC managed in the Cancer Research Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran from 1991 to 2018. All patients were followed to check the patients' status. The data were analyzed regarding demographic, clinical, pathological, and molecular biology characteristics. Descriptive and survival analyses were performed. Kaplan Meier and Cox proportional hazards regression models were used for survival analysis.

Results: Overall, 4, 429 women were included. The mean age was 49. 11 (±11. 98) yr. Nearly 70% of the patients had high school degrees. Totally, 35% of patients were diagnosed in the advanced stages of BC. Estrogen Receptor (ER), Progesterone Receptor (PR), and human epidermal growth factor receptor 2 (HER2) were positive in 72. 50%, 66. 90%, and 16. 20% of the cases, respectively. About 11. 6% of patients died. The overall 5-, 10-, and 15-year survival rates of BC were 90%, 83%, and 75%, respectively. In the Cox proportional hazard analysis, the survival rate was affected by literacy level, positive lymph nodes, lymphovascular invasion, ER, tumor size, and pathological grade.

Conclusion: This is the first report on the 15-year survival rate of BC and its influential factors, from a medical center in Iran. The results were acceptable and comparable with those of developed countries due to scientific protocols, teamwork, and effective follow-up in a developing country.