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Year : 2018  |  Volume : 55  |  Issue : 1  |  Page : 16--22

Breast cancer in a tertiary cancer center in India - An audit, with outcome analysis

Nita Nair1, Tanuja Shet2, Vani Parmar1, Rohini Havaldar3, Sudeep Gupta4, Ashwini Budrukkar5, Rajiv Sarin6, Meenakshi Thakur7, Sangeeta Desai2, Prabha Yadav1, Rakesh jalali5, Seema Gulia7, Tabassum Wadasadawala5, Jaya Gosh4, Jyoti Bajpai4, Seema Kembhavi7, Asawari Patil2, Shalaka Joshi1, Palak Popat7, Venkatesh Rangarajan8, Sneha Shah8, Vaibhav Vanmali3, Shabina Siddiqui3, Indraneel Mittra1, Rajendra Badwe1 
1 Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
2 Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
3 Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India
4 Department of Medical oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
5 Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
6 I/C Cancer Genetic Unit, Tata Memorial Hospital, Mumbai, Maharashtra, India
7 Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
8 Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Tanuja Shet
Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra
India

Background: Survival studies may serve as benchmarks to develop cancer-related policies and estimate baseline survival rates in a given patient population. Materials and Methods: We carried out a retrospective audit of cases managed in 2009 and now report the disease-free survival (DFS) in early breast cancer (EBC) and locally advanced breast cancer (LABC) in patients registered at a tertiary cancer center in India. Results: The study included 2192 patients with breast cancer with ages ranging from 18 years to 94 years with a median of 50 years. Of these, 888 (40.5%) were EBCs Stage I and II, 833 (38%) were LABCs (Stage III), and 471 (21.5%) were de novo metastatic or relapsed cancers at presentation. The 5-year DFS in the women with EBC was 85.5% and in LABC, it was 67.7%, P < 0.001. The factors adversely affecting DFS in EBC were node metastasis (P < 0.001), higher metastatic nodes (P < 0.001), hormone receptor negativity (P = 0.001), and human epidermal growth factor receptor 2 (Her2neu) positivity (P = 0.033). In the multivariate Cox regression analysis in EBC, node-positive status (hazard ratio [HR] 2.28, 95% confidence interval [CI] 1.51–3.45, P < 0.001) and hormone receptor negative tumors (HR 1.96, 95% CI 1.30–2.94, P = 0.001) significantly affected DFS in EBC. The factors adversely affecting DFS in LABC in the univariate analysis were node metastasis (P < 0.001), increasing numbers of nodes (P < 0.001), presence of lymphovascular emboli (LVE) (P < 0.01), mastectomy (P < 0.001), and Her2neu positivity (P = 0.03). In the multivariate Cox regression analysis, node positivity (HR 2.96, 95% CI 2.04–4.29, P < 0.0001), presence of LVE (HR 1.47, 95% CI 1.06–2.04, P = 0.023), and mastectomy (HR 1.49, 95% CI 1.06–2.10, P = 0.023) adversely impacted DFS in LABC. Conclusions: The survival rates in this study are equal to the documented global rates; nodal disease burden emerged as the most important prognostic factor. In addition, in EBCs, a lack of hormone receptor expression and in LABC, Her2neu overexpression appear to worsen the outcome.


How to cite this article:
Nair N, Shet T, Parmar V, Havaldar R, Gupta S, Budrukkar A, Sarin R, Thakur M, Desai S, Yadav P, jalali R, Gulia S, Wadasadawala T, Gosh J, Bajpai J, Kembhavi S, Patil A, Joshi S, Popat P, Rangarajan V, Shah S, Vanmali V, Siddiqui S, Mittra I, Badwe R. Breast cancer in a tertiary cancer center in India - An audit, with outcome analysis.Indian J Cancer 2018;55:16-22


How to cite this URL:
Nair N, Shet T, Parmar V, Havaldar R, Gupta S, Budrukkar A, Sarin R, Thakur M, Desai S, Yadav P, jalali R, Gulia S, Wadasadawala T, Gosh J, Bajpai J, Kembhavi S, Patil A, Joshi S, Popat P, Rangarajan V, Shah S, Vanmali V, Siddiqui S, Mittra I, Badwe R. Breast cancer in a tertiary cancer center in India - An audit, with outcome analysis. Indian J Cancer [serial online] 2018 [cited 2019 Sep 16 ];55:16-22
Available from: http://www.indianjcancer.com/article.asp?issn=0019-509X;year=2018;volume=55;issue=1;spage=16;epage=22;aulast=Nair;type=0