Chala Yadessa, Techane Tesfaye, Bekele Bonsisa, Girma Tesfaye, Fekede Warati, Abdeta Chalchisa, Mardasa Kibiru, Abdeta Tolera, Teshome Bedada, Atinkut Gashaye, Wako Abdinasir, Adem Mohammed, Deksisa Alem
Madda Walabu University Goba Referral Hospital, Goba, Ethiopia.
Department of Oncology, Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
J Cancer Res Clin Oncol. 2025 Jun 12;151(6):187. doi: 10.1007/s00432-025-06181-2.
Breast cancer recurrence is a significant concern when the disease returns following surgery. The time to recurrence and factors affecting it are not well studied in low-income countries. This study aimed to assess the time to recurrence and predictors of breast cancer among women treated in public hospitals of Addis Ababa, Ethiopia.
Retrospective cohort study was conducted from April 30 to May 30, 2024, among randomly selected 322 recorded cases. The study covered from September 11, 2018, to September 12, 2023. Data were collected by the Kobo toolbox and analyzed by Stata Version 15. The Cox proportional hazard model was used to identify predictor variables, with assumptions checked using the Schoenfeld residual/global test (0.79). Multi-collinearity was checked using the variance inflation factor (3.72). Variables with a P-value < 0.25 in bivariable analysis were entered into the final multivariable analysis. Variables with a P-value < 0.05 at 95% confidence level were considered independent predictors of recurrence.
The recurrence-free survival (RFS) status at the median follow-up time was 87.5%. The incidence rate of breast cancer recurrence was 6.8 per 100 women years (95%CI = 5.34-8.13) follow-up. The 75%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 (AHR = 2.1; 95%CI 1.20-4.02), axillary node-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 recurrence.
This study confirms a substantial incidence of breast cancer recurrence, with identifiable predictors including comorbidity, age, overweight, positive axillary node status, lymph node involvement, and deep surgical margin. Targeted interventions aimed at improving patient understanding of recurrence risk, promoting adherence to treatment protocols, and fostering healthy lifestyle modifications are crucial for reducing recurrence rates.
乳腺癌复发是疾病手术后复发时的一个重大问题。低收入国家对复发时间及其影响因素的研究尚不充分。本研究旨在评估埃塞俄比亚亚的斯亚贝巴公立医院接受治疗的女性乳腺癌的复发时间及预测因素。
2024年4月30日至5月30日进行了一项回顾性队列研究，随机选取322例记录病例。研究涵盖2018年9月11日至2023年9月12日。数据通过Kobo工具箱收集，并使用Stata 15版本进行分析。采用Cox比例风险模型识别预测变量，并使用Schoenfeld残差/全局检验（0.79）检查假设。使用方差膨胀因子（3.72）检查多重共线性。在双变量分析中P值<0.25的变量进入最终多变量分析。在95%置信水平下P值<0.05的变量被视为复发的独立预测因素。
中位随访时间的无复发生存（RFS）状态为87.5%。乳腺癌复发的发病率为每100名女性年6.8例（95%CI = 5.34 - 8.13）随访。75%RFS时间为44个月（95CI% = 40 - 48）。24、36、48和60个月时的RFS生存率分别为91.93%、83.3%、67.7%和61%。40岁及以下的女性（AHR = 3.32；95%CI 1.80 - 5.88）、超重（AHR = 1.95，95%CI 1.06 - 3.59）、手术切缘阳性（AHR = 2.1；95%CI 1.20 - 4.02）、腋窝淋巴结阳性（AHR = 1.98；95%CI 1.08 - 3.61）和合并症（AHR = 4.45，95%CI 2.39 - 8.30）是复发风险增加的独立预测因素。
本研究证实乳腺癌复发的发生率较高，可识别的预测因素包括合并症、年龄、超重、腋窝淋巴结阳性状态、淋巴结受累和手术切缘较深。旨在提高患者对复发风险的认识、促进对治疗方案的依从性以及培养健康生活方式改变的针对性干预对于降低复发率至关重要。
