Clinical characteristics of breast cancer patients diagnosed and treated at the American University of Beirut Medical Center (AUBMC) from 1990 to 2001
Category: Adjuvant Therapy
Abstract No: 341
M. Seoud, J. Abbas, M. Khalil, M. Charafeddine, Z. Salem, N. El-Saghir, F. Geara, A. Shamseddine;
American University of Beirut, Beirut, Lebanon
Abstract: This is a hospital-based, retrospective analysis of the clinical characteristics of patients treated at AUBMC between 1990 and 2001.
Methods: Data on 836 breast cancer patients was retrieved from hospital,radiotherapy and pathology departments' records. Follow-up was obtained from private clinics charts and by phone.The data was analyzed using SPSS.
Chi-square,linear regression analyses and the life time table were used ,p<0.05 was considered significant.Results: The mean age at diagnosis was 51.4 ±12.11 yrs.58.7 % of patients were post-menopausal. 88.2% had infiltrating ductal Ca vs. 5.2% with infiltrating lobular Ca and 16% with DCIS.Since 1990, a decrease in the percentage of patients diagnosed with stage III was noted with an increase in stages I&II (41.3% stage III in 1990 vs.6.3% in 2001 with a p=0.00).
An increase in conservative surgery vs. mastectomy was noted(1.9 % in 1990 vs.43.2% conservative in 2001,p=0.00).CMF regimens decreased compared to Adria-containing regimens (53.3 % Adria-containing in 1990 vs. 75.5 % adria- containing in 2001, p=0.027) and an improvement in survival with Adria-containing regimens in stage 2&3 patients vs.CMF regimens in the years 2000/01(3.2% on Adria developed metastasis vs. 33.3% on CMF).
All patients with stage I survived; for stages II,III,IV after a mean follow-up period of 3.8 ±3.1, 3.5 ±3.1 and 2.1 ±2.2 years respectively 9.7%, 16.6%, and 27.4% died respectively. For patients with stages I, II, III and IV
The expected 5-year survival was 100%, 66%, 53% and 17%. In stages II and III, 91 and 51 patients respectively had a mean time to progression of 35.7 ±30.5 and 34.6 ±35.8 months. In patients with stage II, ER and PGR had a significant effect on survival (5.2% and 3.8% of ER and PGR positive patients died respectively compared with 13.6% and 13.6% of ER and PGR negative with p=0.013 and 0.04 respectively).
Conclusion: Lebanese patients present at a much earlier age than in USA and Europe.A recent increase in early diagnosis of breast cancer associated with an increase in conservative surgery is noted. There was also an increase in use of Adria-containing regimens.
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