Time to recurrence and predictors of breast cancer among women patients treated in public hospitals of Addis Ababa, Ethiopia, 2024.

Abstract

Abstract Introduction: Breast cancer is a disease causing uncontrollable changes in breast tissue cells. Breast cancer recurrence is declared when the disease returns following surgery. Time to breast cancer recurrence and factors affecting it are not well studied in Ethiopia. Therefore, the aim of this study was to assess time to recurrence and predictors of breast cancer among women patients treated in public hospitals of Addis Ababa, Ethiopia, 2024. Methods: Two public hospitals were selected by lottery method; a retrospective cohort study design was conducted from April 30- May 30, 2024 among randomly selected 322 of medical records. The study covered the period from September 11, 2018 to September 12, 2023. Sample size was allocated proportionally to TASH and SPHMMC, and medical records of patients were tracked from sample frame randomly. Data were collected by kobo toolbox and analyzed by Stata Version 15. To identify predictor‟s variables, the Cox proportional hazard model was used. The Cox-proportional hazard model assumption was checked using Schoenfeld residual/global test (0.79). Multi-colinearity was checked using variance inflation factor (3.72). Variables with P-value < 0.25 in bivariate analysis were entered into the final multivariate analysis. Variable with P-value <0.05 at 95% confidence level were considered as independent predictors of recurrence. Result: The study response rate was 96%. The incidence rate of breast cancer recurrence was 6.8 per 100 women years (95%CI=5.34-8.13) follow-up. The75%RFS time was 44 months (95CI%=40-48). The proportion of RFS survival at 24, 36, 48, and 60 months was 91.93%, 83.3%, and 67.7%, 61% respectively. Women aged 40 & below (AHR=3.32; 95%CI: 1.80- 5.88), Overweight (AHR=1.95, 95%CI:1.06-3.59), surgical margin positive at diagnosis (AHR=2.1; 95%CI: 1.20-4.02), axillary node status positive (AHR=1.98; 95%CI: 1.08-3.61) and comorbidity (AHR=4.45, 95%CI: 2.39-8.30) were independent predictors for increased hazard of breast cancer recurrence. Conclusion and Recommendation: The incidence of breast cancer recurrence is high with predictors of recurrence include comorbidity, age, overweight, positive axillary node status, lymph node involvement, and deep surgical margin contributing to higher rates. Improving awareness and patient education on prevention, screening, and treatment is crucial. Key words: Breast, cancer, Ethiopia, Predictors, recurrence