Determining the Factors Affecting Long-Term and Short-Term Survival of Breast Cancer Patients in Rafsanjan Using a Mixture Cure Model

Abstract

Background: Breast cancer is one of the most common causes of death among women worldwide and the second leading cause of death among Iranian women. The incidence of this malignancy in Iran is 22 per 100,000 women. These patients have long-term survival time with advances in medical sciences. The present study aimed to identify the risk factors of breast cancer using Cox proportional hazard and Cox mixture cure models. Study design: It is a retrospective cohort study. Methods: In this cohort study, we recorded the survival time of 140 breast cancer patients referred to Ali Ibn Abitaleb Hospital in Rafsanjan, Iran, from 2001 to 2015. The Kaplan-Meier curve was plotted; moreover, two Cox proportional hazards and the Cox mixture cure models were fitted for the patients. Data analysis was performed using SAS 9.4 M5 software. Results: The mean age of patients was reported as 47.12 ±12.48 years at the commencement of the study. Moreover, 83.57% of patients were censored. The stage of disease was a significant variable in Cox and the survival portion of Cox mixture cure models (P=0.001). The consumption of herbal tea, tumor size, duration of the last lactation, family history of cancer, and the type of treatment were significant variables in the cured proportion of the Cox mixture cure model (P=0.001). Conclusion: The Cox mixture cure model is a flexible model which is able to distinguish between the long-term and short-term survival of breast cancer patients. For breast cancer patients, cure effective factors were the stage of the disease, consumption of herbal tea, tumor size, duration of the last lactation, family history, and the type of treatment.