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Overall survival from breast cancer in Kerala, India, in relation to menstrual, reproductive, and clinical factors
Author(s) -
Nair M. Krishnan,
Sankaranarayanan R.,
Nair K. Sukumaran,
Amma N. Sreedevi,
Varghese Cherian,
Padmakumari G.,
Cherian Thomas
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930301)71:5<1791::aid-cncr2820710513>3.0.co;2-w
Subject(s) - medicine , breast cancer , stage (stratigraphy) , proportional hazards model , survival analysis , survival rate , gynecology , cancer , oncology , retrospective cohort study , obstetrics , paleontology , biology
Background . Breast cancer accounts for one‐fourth of cancer cases seen in female patients in Kerala, India. Results of a retrospective analysis of breast cancer in Kerala are presented in this article. Methods . Case records of 449 patients with breast carcinoma treated during 1983–1984 were reviewed. Survival analysis was done by the Kaplan–Meier product limit method. The survival curves were compared by the log‐rank test. A forward stepwise procedure with the Cox proportional hazards regression analysis was performed to identify factors influencing survival. Results . The overall 5‐year survival rate was 40%. The 5‐year survival rates were 85% for patients with T1, 63% for T2, 32% for T3, and 21% for T4 lesions. Those with N0 disease had a 68% 5‐year survival rate. The survival rates were 90% for patients with Stage I, 65% for Stage II, 33% for Stage III, and 6% for Stage IV disease. On multivariate analysis, the following factors were found to significantly influence survival: response to treatment ( P < 0.001), stage ( P < 0.01), and regional nodal involvement ( P < 0.05). Conclusions . Two‐thirds of patients with advanced‐stage disease on presentation seem to account for the poor overall survival. Early detection of breast cancer by breast self‐examination and physician breast examination should be encouraged in developing countries to improve treatment results in breast cancer.