Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Comprehensive Breast Care on Breast Cancer Outcomes: A Community Hospital Based Study from Mumbai, India

  • Published : 2012.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

Keywords

References

  1. Ahmad Z, Khurshid A, Qureshi A, et al (2009). Breast carcinoma grading, estimation of tumor size, axillary lymph node status, staging, and nottingham prognostic index scoring on mastectomy specimens. Indian J Pathol Microbiol, 52, 477-81. https://doi.org/10.4103/0377-4929.56123
  2. Dikshit R, Kanhere S, Surange S (2011). Cancer survival in Bhopal, India, 1991-1995. In 'Cancer Survival in Africa, Asia, the Caribbean and Central America', Eds Sankaranarayanan R and Swaminathan R. International Agency for Research on Cancer, Lyon pp. 107-13.
  3. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) 'GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet].' International Agency for Research on Cancer: Lyon.
  4. Gajalakshmi CK, Shanta V, Swaminathan R, et al (1997). A population-based survival study on female breast cancer in Madras, India. Br J Cancer, 75, 771-5. https://doi.org/10.1038/bjc.1997.137
  5. Ganesh B, Talole SD, Dikshit R, et al (2008). Estimation of survival rates of breast cancer patients--a hospital-based study from Mumbai. Asian Pac J Cancer Prev, 9, 53-7.
  6. Host H, Lund E (1986). Age as a prognostic factor in breast cancer. Cancer, 57, 2217-21. https://doi.org/10.1002/1097-0142(19860601)57:11<2217::AID-CNCR2820571124>3.0.CO;2-T
  7. Hussain SK, Altieri A, Sundquist J, et al (2008). Influence of education level on breast cancer risk and survival in Sweden between 1990 and 2004. Int J Cancer, 122, 165-9. https://doi.org/10.1002/ijc.23007
  8. Jacobson JA, Danforth DN, Cowan KH, et al (1995). Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med, 332, 907-11. https://doi.org/10.1056/NEJM199504063321402
  9. Jayalekshmi P, Gangadharan P, Sebastian P (2011). Cancer survival in Karunagappally, India, 1991-1997. In 'Cancer Survival in Africa, Asia, the Caribbean and Central America', Eds Sankaranarayanan R and Swaminathan R. International Agency for Research on Cancer, Lyon pp. 125-32.
  10. Kogevinas M, Porta M (1997). Socioeconomic differences in cancer survival: a review of the evidence. In 'Social Inequalities and Cancer. IARC Scientific Publications, No 138.', Eds Kogevinas M, Pearce N, Susser M, and Boffetta P. International Agency for Research on Cancer, Lyon pp. 177-206.
  11. Nair MK, Sankaranarayanan R, Nair KS, et al (1993). Overall survival from breast cancer in Kerala, India, in relation to menstrual, reproductive, and clinical factors. Cancer, 71, 1791-6. https://doi.org/10.1002/1097-0142(19930301)71:5<1791::AID-CNCR2820710513>3.0.CO;2-W
  12. Nandakumar A, Anantha N, Venugopal TC, et al (1995). Survival in breast cancer: a population-based study in Bangalore, India. Int J Cancer, 60, 593-6. https://doi.org/10.1002/ijc.2910600504
  13. Okugawa H, Yamamoto D, Uemura Y, et al (2005). Prognostic factors in breast cancer: the value of the Nottingham Prognostic Index for patients treated in a single institution. Surg Today, 35, 907-11. https://doi.org/10.1007/s00595-005-3056-x
  14. Poggi MM, Danforth DN, Sciuto LC, et al (2003). Eighteenyear results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer, 98, 697-702. https://doi.org/10.1002/cncr.11580
  15. Raina V, Bhutani M, Bedi R, et al (2005). Clinical features and prognostic factors of early breast cancer at a major cancer center in North India. Indian J Cancer, 42, 36-41.
  16. Rostgaard K, Mouridsen HT, Vaeth M, et al (2001). A modified Nottingham prognostic index for breast cancer patients diagnosed in Denmark 1978-1994. Acta Oncol, 40, 838-43. https://doi.org/10.1080/02841860152703463
  17. Sankaranarayanan R, Ramadas K, Thara S, et al (2011). Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst, 103, 1476-80. https://doi.org/10.1093/jnci/djr304
  18. Sankaranarayanan R, Swaminathan R (2011) 'Cancer Survival in Africa, Asia, the caribbean and Central America. IARC Scientific Publications No. 162.' International Agency for Research on Cancer: Lyon
  19. Sankaranarayanan R, Swaminathan R, Brenner H, et al (2010). Cancer survival in Africa, Asia, and Central America: a population-based study. Lancet Oncol, 11, 165-73. https://doi.org/10.1016/S1470-2045(09)70335-3
  20. Swaminathan R, Rama R, Nalini S, Shanta V (2011). Cancer survival in Chennai (Madras), India, 1990-1999. In 'Cancer Survival in Africa, Asia, the Caribbean and Central America', Eds Sankaranarayanan R and Swaminathan R. International Agency for Research on Cancer, Lyon pp. 115-24.
  21. Wittekind C, Hutter R, Greene FL, Klimpfinger M, Sobin LH (2005) 'UICC. TNM Atlas: Illustrated Guide to the TNM Classification of Malignant Tumours, 5th edition.' John Wiley & Sons: Hoboken, New Jersey
  22. Yeole BB, Kumar AV, Kurkure A, et al (2004). Population-based survival from cancers of breast, cervix and ovary in women in Mumbai, India. Asian Pac J Cancer Prev, 5, 308-15.
  23. Yeole BB, Kurkure AP, Sunny L (2011). Cancer survival in Mumbai (Bombay), India, 1992-1999. In 'Cancer Survival in Africa, Asia, the Caribbean and Central America', Eds Sankaranarayanan R and Swaminathan R. International Agency for Research on Cancer, Lyon pp. 133-42.

Cited by

  1. Serum Adiponectin but not Leptin at Diagnosis as a Predictor of Breast Cancer Survival vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6137