Survival analysis of women breast cancer patients in Northwest Amhara, Ethiopia

Abstract

Introduction: Breast cancer, the most common cause of cancer death and the most frequently diagnosed cancer among women worldwide, ranks as the second cause of death next to lung cancer. Thus, the main objective was to assess the factors that affect the survival time of breast cancer patients using the shared frailty model. Methods: A retrospective study design was used to collect relevant data on the survival time of breast cancer patients from the medical charts of 322 breast cancer patients under follow-up at the Felege Hiwot Comprehensive Specialized Hospital (FHCSH). The data were explored using the Cox proportional hazard model, the accelerated failure time model, and shared frailty models. The model comparison was done using AIC and BIC. As a result, the Weibull gamma shared frailty model had a minimum AIC and BIC value. Result: From a total of 322 patients, about 95 (29.5%) died and 227 (70.5%) were censored. The overall mean and median estimated survival times of breast cancer patients under study were 43.7 and 45 months, respectively. The unobserved heterogeneity in the population of clusters (residence) as estimated by the Weibull-gamma shared frailty model was 0.002 (p-value = 0.000), indicating the presence of residential variation in the survival time of breast cancer patients. The estimated hazard rate of patients who had not had recurrent breast cancer was 0.724 (95% CI: 0.571, 0.917) times the estimated hazard rate of patients who had had recurrent breast cancer. Conclusion: The prevalence of breast cancer was considerably high. Under this investigation, older patients, patients in stages III and IV, anemic and diabetes patients, patients who took only chemotherapy treatment, metastasized patients, patients with an AB blood type, patients with a positive breast cancer family history, and patients whose cancer was recurrent had high death rates. Patient characteristics such as age, stage, complications, treatment, metastasis, blood type, family history, and recurrence were significant factors associated with the survival time of women with breast cancer.