Prognostic factors and overall survival of breast cancer in Benin: a hospital-based study

Abstract

Abstract Background In Benin, a country in West Africa, breast cancer is the leading cancer in women, both in terms of incidence and mortality. However, evidence on the mortality of breast cancer and its associated factors is lacking in this country. Our aim was to describe and analyze the clinical, histopathological, and prognostic aspects of breast cancer in Benin. Methods A descriptive and analytical study was carried out at the CNHU-HKM and the CHU-MEL, two major referral hospitals for breast cancer management located in Cotonou, the capital city of Benin. All breast cancer medical records with histological evidence and immunohistochemistry studies were retrospectively collected between January 1, 2014, and September 30, 2020, in these two referral hospitals and analyzed in this study. Results We included 319 medical records. The mean age at diagnosis was 48.74 years. The tumors were most frequently classified as T4 (47.6%) with lymph node involvement N2 (34.5%), and metastases were clinically noted in 21.6% of cases. Tumors were diagnosed at very late AJCC stages: stage 3 (42.3%) and stage 4 (21.9%). Grades SBR 2 (49.2%) and SBR 3 (32.6%) were the most frequent grades. Triple-negative breast cancer (31.3%) was the most common molecular type. The overall 5-year survival was 48.49%. In multivariable analysis, the poor prognostic factors were lymph node invasion (HR = 2.63; p = 0.026; CI: [1.12, 6.17]), the presence of metastasis (HR = 3.64; p < 0,001); CI: [2.36, 5.62] and the immunohistochemical profile (HR = 1.29; p < 0,001; CI: [1.13, 1.48]). Conclusions Breast cancer in Beninese is predominant in young adults and is often diagnosed at a late stage. The survival of breast cancer patients in Benin can be improved by enhancing early diagnosis and multidisciplinary management.