Assessment of histopathology patterns of breast cancer managed at Alexandria cancer center and palliative care hospital, Eldoret, Uasin Gishu County, Kenya

Abstract

Background: Globally approximately 2.3 million cases of breast cancer were reported in 2022. These cases were distributed among different histopathological sub- types. In sub-Saharan Africa 186,598 cancer cases were diagnosed in 2022 and 85,787 deaths occurred annually. In Kenya of the 5985 new cases reported breast cancer contributed 12.5% of all cancer cases. D etailed data on patient characteristics, survival rates, and factors influencing mortality among breast cancer patients at the Alexandria Cancer Center and Palliative Care Hospital (ACCPH) is lacking, hindering effective management and treatment strategies . Objective: To determine the characteristics of patients with breast cancer, proportion of different histopathological sub-types of breast cancer and survival. Methods: The study was conducted at ACCPH using a cross-sectional study design. Census of all patients who met the inclusion criteria and managed between 2016 and 2019 at ACCPH were included. Data was collected from records using a data abstraction tool. Mean and standard deviation were employed to summarize continuous variables while proportions and frequencies were used for categorical variables. Kaplan-Meier (K-M) survival estimates procedure was used to analyze the 2-year survival time. Cox regression model was fitted to assess predictors of survival time, significance evaluated at p-value <0.05. Results: Fifty four cases were studied, 52 females and 2 males. Females contributed the highest number and 40 to 49 years (33.3% of the total) was the peak age. Invasive ductal carcinoma accounted for 88.7%, 2-year survival rate was 64.8%. Metastases at diagnosis and disease progression were factors associated with risk of death with a p-value < 0.001. Gender, age and metastasis were also significantly associated with survival time. Conclusion: The most affected age group was 40 to 49 years, invasive ductal carcinoma was the commonest histological sub-type, a significant number of cases presented with metastasis an indicator of late presentation. Majority of the cases were alive 2 years post diagnosis. Those who had metastasis had a higher likelihood of dying. Recommendations: Breast cancer screening among the females above 40 years old. Reduction of risk of metastasis by creating awareness for early diagnosis to further improve the 2-year survival rate.