Survival analysis of breast cancer patients in northwest Iran

In Iran, breast cancer (BC) is ranked first among malignancies ofwomen, comprising 24.4% of all neoplasms with a crude incidence rate of 17.81in the year of 2006. However, studies specifically describing theclinicopathologic features, stages, and age distributions of BC in Iran arelimited; thus, it is difficult to predict the present and future patterns of BC andcarry out the most appropriate preventive and therapeutic measures to decreasethe burden of the disease in Iran. Some studies in southern Iran about survivalpattern of BC found three- and five-year overall survival rates of 76% and 58%respectively. The aim of this study was to determine the survival rate andprognostic factors of BC in northwest Iran.Methods and patients:A cohort study of 271 patients recruited from 1376- 87,in Tabriz, northwest of Iran. In this study we analyzed the age, tumor diameter,nodal status, hormone receptor status, pattern of metastasis and survival rate ofbreast cancer patients who referred to a university clinic in Tabriz, the city inthe northwest of Iran and compared it with the results of other cities in Iran andother countries.Results: Mean age was 48(26-82), 116 were ER and PR positive, 104 and 103were negative. In fifteen years follow up 52 patients died. 14 patients werebelow 40 years old. 109 patients were premenopause, 83 postmenopause, and43 unknown. 36.1% had tumor> 4 cm and 9.5% <2 cm. 18.6% had N1, 14.4%N2, 12.8% N3,16.7% unknown, 27.5% negative, 53.5% positive. 51.1% withmetastasis, (26.6% nonskeletal, 24.5% skeletal, 1.4% both).Life table analysis showed one, three, five and seven years overall survival of86, 81, 79, and 76% respectively. It showed statistically significant correlationof survival with age less or above 40 years. Patients less than 40 years old hadone, three and five years survival of 82, 74, and 65 % wile patients over 40 had95, 86, and 83% respectively (log rank=0.22). Diameter of the tumor hadminimal effect to survival (T> 4 cm had lower survival, P=0.08).Discussion:Two studies have previously reported 5-year overall breast cancersurvival rates in Tehran and these were 60% and 62%. Our study shows similarresults and denotes that Iran has considerably poorer survival than Europeancountries and the United States.Age less than 40 may be a prognostic factor innorthwest Iran