がんの科学と治療

Prognostic Factors Associated with Survival in Women with Breast Cancer from Veracruz, Mexico

Abstract

María Teresa Álvarez-Bañuelos, Ligia María Rosado-Alcocer, Jaime Morales-Romero, Lizbeth San Román-Álvarez, Raúl Enrique Guzmán- García and Magda Carvajal-Moreno

Objective: The present study analyzed the geographical location and prognostic, clinical, physiological, and biochemical factors associated with breast cancer (BC) in women based on their treatment.
Methods: We conducted a retrospective cohort study encompassing a 5-year follow-up period of 114 women from rural and urban areas who were diagnosed with BC in 2009 at the State Cancer Center (CECAN) in Xalapa, Veracruz, Mexico. The probability of survival was calculated using the Kaplan-Meier estimator and Log Rank test with a confidence interval of 95%. We determined the prognostic factors in a multivariate analysis using the Cox proportional hazards model. The point estimate was the hazard ratio (HR) and 95% confidence interval (CI).
Results: The overall survival ratio for the study participants was 68% and 63% after 52 and 60 months, respectively. The lowest survival ratio corresponded to clinical stages IIIB (38%) and IV (10%) and patients showing tumor cell metastasis (24%). There were significant differences between groups (p<0.001), including women under 40 years of age (36%, p<0.003) and those with positive HR (83%, p=0.006). Women who received adjuvant treatment and had a tumor size less than 2 cm lived longer (75%, p<0.001). The multivariate analysis identified a number of prognostic factors that are unfavorable for women with BC, including a diagnosis of clinical stage IV (Hazard Ratio=11.88; 95% CI=2.88-44.88) and the presence of metastasis (Hazard Ratio=4.95; 95% CI=1.78-13.76).
Conclusion: General tumor characteristics, such as metastasis, disease stage and family history, are important for survival and can serve as prognostic factors for BC patients. Moreover, the lower survival of women less than 40 years of age should be considered as a decision-making factor when selecting from treatment options.