Survival analysis of 1148 women diagnosed with breast cancer in Southern Iran

BACKGROUND: While there has been much research regarding risk factors and prognostic factors for breast cancer in general, research specific to Iran is sparse. Further, the association between breast cancer survival and socio-demographic and pathologic factors has been widely studied but the majority of these studies are from developed countries. Southern Iran has a population of approximately 4 million. To date, no research has been performed to determine breast cancer survival and to explore the association between the survival and socio-demographic and pathologic factors in Southern Iran, where this study was conducted. METHODS: The data were obtained from the cancer registry in Fars province, Southern Iran and included 1148 women diagnosed with breast cancer between 2000 and 2005. The association between survival, and sociodemographic and pathological factors, distant metastasis at diagnosis, and treatment options was investigated using Cox regression. RESULTS: The majority of patients were diagnosed with an advanced tumour size. Five-year overall survival was 58% (95%CI; 53%–62%). Cox regression showed that family income (good vs poor: hazard ratio 0.46, 95%CI; 0.23–0.90) smoking (HR = 1.40, 95%CI; 1.07–1.86), metastases to bone (HR = 2.25, 95%CI; 1.43–3.52) and lung (HR = 3.21, 95%CI;1.70–6.05), tumour size (≤ 2 cm vs ≥ 5 cm: HR = 2.07, 95%CI;1.39–3.09) and grade (poorly vs well differentiated HR = 2.33, 95%CI; 1.52–3.37), lymph node ratio (0 vs 1: HR = 15.31, 95%CI; 8.89–26.33) and number of involved node (1 vs >15: HR = 14.98, 95%CI; 8.83–25.33) were significantly related to survival. CONCLUSION: This is the first study to evaluate breast cancer survival in Southern Iran and has used a wide range of explanatory factors, 44. The results demonstrate that survival is relatively poor and is associated with diagnosis with late stage disease. We hypothesise that this is due to low level of awareness, lack of screening programs and subsequent late access to treatment.