Community Physician, Ministry of Health and Wellness, Port Louis, Mauritius.
Faculty of Medicine and Health Science, University of Mauritius, Reduit, Mauritius.
Int J Cancer. 2025 Jan 15;156(2):331-338. doi: 10.1002/ijc.35172. Epub 2024 Sep 7.
Breast cancer is by far the leading cancer both in terms of incidence and mortality in the Republic of Mauritius, a Small Island Developing State (SIDS). However, few studies assessed its survival by age, stage at diagnosis and molecular subtype. We identified 1399 breast cancer cases newly diagnosed between 2017 and 2020 at the Central Health Laboratory, Victoria Hospital. Cancers were categorized into five molecular subtypes: (1) luminal A, (2) luminal B Her2 negative, (3) luminal B Her2 positive, (4) Her2 enriched and (5) Triple negative. The net 1 and 3-year survival were estimated for different age groups, staging at time of diagnosis and molecular subtype. We also estimated the excess hazards using a multivariate Cox proportional hazards model. While early stage at diagnosis (stage 1 [44.4%] and stage 2 [20.1%]) were most common compared to late presentation (Stage 3 [25.4%] and stage 4 [10.1%]), luminal B Her2 negative (36.7%) was the most frequent molecular subtype. The net 1- and 3-year breast cancer survival rates were 93.9% (92.3-95.4) and 83.4% (80.4-86.4), respectively. Breast cancer three-year survival rates were poorest among the youngest patients (<50 years), 77.1% (70.7-83.5), those diagnosed with stage 4 (28.5% [17.1-39.9]) and cancer with a triple negative molecular subtype (71.3% [63.3-79.3]). Emphasis on a national breast cancer screening programme, down staging breast cancer at diagnosis and systematic molecular subtyping of all breast tissues could be pivotal in improving breast cancer survival outcomes in the Republic of Mauritius.
在毛里求斯这个小岛屿发展中国家，乳腺癌无论在发病率还是死亡率方面均是最主要的癌症。然而，很少有研究按年龄、诊断时的分期和分子亚型评估其生存率。我们在维多利亚医院中央卫生实验室鉴定了 1399 例 2017 年至 2020 年间新诊断的乳腺癌病例。癌症分为五个分子亚型：（1）管腔 A 型，（2）管腔 B Her2 阴性型，（3）管腔 B Her2 阳性型，（4）Her2 富集型和（5）三阴性型。我们按不同年龄组、诊断时的分期和分子亚型估计了 1 年和 3 年的净生存率。我们还使用多变量 Cox 比例风险模型估计了超额风险。尽管早期诊断（1 期[44.4%]和 2 期[20.1%]）比晚期表现（3 期[25.4%]和 4 期[10.1%]）更为常见，但管腔 B Her2 阴性（36.7%）是最常见的分子亚型。乳腺癌的 1 年和 3 年净生存率分别为 93.9%（92.3-95.4）和 83.4%（80.4-86.4）。年龄最小的患者（<50 岁）的乳腺癌 3 年生存率最差，为 77.1%（70.7-83.5），诊断为 4 期的患者为 28.5%（17.1-39.9），三阴性分子亚型的癌症患者为 71.3%（63.3-79.3）。强调国家乳腺癌筛查计划、降低诊断时的分期和对所有乳腺组织进行系统的分子亚型分析，可能对提高毛里求斯乳腺癌的生存结果至关重要。
