Survival Time and Prognostic Factors for Breast Cancer among Women in North-East Peninsular Malaysia

Background: Breast cancer is the most common malignant disease and the leading cause of cancer death among
women globally. This study aimed to determine the median survival time and prognostic factors for breast cancer
patients in a North-East State of Malaysia. Methods: This retrospective cohort study was conducted from January till
April 2017 using secondary data obtained from the state’s cancer registry. All 549 cases of breast cancer diagnosed
from 1st January 2007 until 31st December 2011 were selected and retrospectively followed-up until 31st December
2016. Sociodemographic and clinical information was collected to determine prognostic factors. Results: The average
(SD) age at diagnosis was 50.4 (11.2) years, the majority of patients having Malay ethnicity (85.8%) and a histology of
ductal carcinoma (81.5%). Median survival times for those presenting at stages III and IV were 50.8 (95% CI: 25.34,
76.19) and 6.9 (95% CI: 3.21, 10.61) months, respectively. Ethnicity (Adj. HR for Malay vs non-Malay ethnicity=2.52;
95% CI: 1.54, 4.13; p<0.001), stage at presentation (Adj. HR for Stage III vs Stage I=2.31; 95% CI: 1.57, 3.39; p<0.001
and Adj. HR for Stage IV vs Stage I=6.20; 95% CI: 4.45, 8.65; p<0.001), and history of surgical treatment (Adj. HR
for patients with no surgical intervention=1.95; 95% CI: 1.52, 2.52; p<0.001) were observed to be the statistically
significant prognostic factors associated with death caused by breast cancer. Conclusion: The median survival time
among breast cancer patients in North-East State of Malaysia was short as compared to other studies. Primary and
secondary prevention aimed at early diagnosis and surgical management of breast cancer, particularly among the Malay
ethnic group, could improve treatment outcome.