Department of Adult Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
PLoS One. 2023 Jan 26;18(1):e0279656. doi: 10.1371/journal.pone.0279656. eCollection 2023.
Breast cancer is one of the common global health concerns that affects2.1 million women each year and causes the highest number of cancer-related morbidity and mortality among women. The objective of this study was to determine the mortality rate and its predictors among breast cancer patients at the referral hospitals, in northwest Ethiopia.
A retrospective follow-up study was conducted on breast cancer patients registered between February 01, 2015 and February 28, 2018. They were selected by simple random sampling using computer-generated method and followed until February 29, 2020, in Amhara region referral hospital. A pre-tested data extraction checklist was used to collect data from the registration book and patient medical records. The collected data were entered into Epi-Data version 3.1 and exported to STATA version 14 for analysis. The mortality rate by person-year observation was computed. The Kaplan-Meier survival curve with the log-rank test was used to estimate the survival probabilities of the patients. Bivariate and multivariate Cox regression model was used to identify predictors of mortality.
The overall mortality rate of breast cancer was 16.9 per 100 person-years observation. The median survival time was 38.3 (IQR: 26.23, 49.4) months. Independent predictors of breast cancer mortality was; Clinical stage IV and stage III (aHR:10.44,95% CI: 8.02,11.93 and aHR: 9.43, 95% CI: 6.29,11.03respectively), number of positive lymph node in the category of 10 and more and number of positive lymph node within the category of 4-9 (aHR:12.58, 95%CI: 5.2, 30.46 and aHR: 4.78, 95% CI: 2.19, 10.43respectively), co-morbidities (aHR:1.5, 95%CI: 1.01,2.21), Postmenopausal (aHR:2.03,95% CI: 1.37, 3), histologic grade III (aHR:2.12, 95% CI: 1.26,3.55) and not received hormonal therapy (aHR: 2.19, 95%CI: 1.52,3.15) were independent predictors of mortality.
The overall mortality rate was 16.9 per 100 person-years. The finding was higher compared to high-income countries. Advanced clinical stage, co-morbidities, menopausal status, and hormonal therapy are the significant predictors of mortality. Early detection and treatment of breast cancer is needed to reduce the mortality rate.
乳腺癌是全球关注的常见健康问题之一，每年影响 210 万女性，并导致女性癌症相关发病率和死亡率最高。本研究的目的是确定在埃塞俄比亚西北部的转诊医院中乳腺癌患者的死亡率及其预测因素。
这是一项回顾性随访研究，对 2015 年 2 月 1 日至 2018 年 2 月 28 日期间在阿姆哈拉地区转诊医院登记的乳腺癌患者进行了研究。使用计算机生成的方法进行简单随机抽样选择患者，并对其进行随访，直至 2020 年 2 月 29 日。使用预先制定的数据提取检查表从登记册和患者病历中收集数据。收集的数据输入到 Epi-Data 版本 3.1 中，并导出到 STATA 版本 14 进行分析。通过人年观察计算死亡率。使用 Kaplan-Meier 生存曲线和对数秩检验估计患者的生存概率。使用双变量和多变量 Cox 回归模型确定死亡率的预测因素。
乳腺癌的总死亡率为每 100 人年观察 16.9 人。中位生存时间为 38.3（IQR：26.23，49.4）个月。乳腺癌死亡的独立预测因素为：临床分期 IV 和 III 期（aHR：10.44，95%CI：8.02，11.93 和 aHR：9.43，95%CI：6.29，11.03），阳性淋巴结数量为 10 个及以上和阳性淋巴结数量为 4-9 个（aHR：12.58，95%CI：5.2，30.46 和 aHR：4.78，95%CI：2.19，10.43），合并症（aHR：1.5，95%CI：1.01，2.21），绝经后（aHR：2.03，95%CI：1.37，3），组织学分级 III 级（aHR：2.12，95%CI：1.26，3.55）和未接受激素治疗（aHR：2.19，95%CI：1.52，3.15）是死亡的独立预测因素。
总体死亡率为每 100 人年 16.9 人。这一发现高于高收入国家。晚期临床分期、合并症、绝经状态和激素治疗是死亡的重要预测因素。需要早期发现和治疗乳腺癌，以降低死亡率。
