Breast Cancer Treatment and Determinants of Five-Year Survival in Two Referral Hospitals in Yaoundé, Cameroon

Background: Breast cancer (BC) mortality and survival rates vary across the globe, with better survival values recorded in developed countries. In Cameroon, data on BC treatment outcome and its determinants are scant. Objective: Our aim was to evaluate the treatment and five-year survival of BC in two referral hospitals in Yaoundé. Methodology: We conducted a retrospective survival cohort study at two referral hospitals in Yaoundé. All files of patients managed for BC from 1^st January 2015 to 31^st December 2019 (5 years) at these hospitals were considered. Data on the socio-demographic and clinical characteristics, and the 5-year survival rate of BC cases was used to produce a Kaplan Meier survival curve. Cox regression enabled the identification of factors associated with BC survival, and calculation of hazard ratios to measure their impact, with significance level set at 5%. Results: We studied 503 cases with mean age 48.4 ± 10.4 years, and range 16 - 78. Majority of cases were female (95.2%), had left breast disease (69.6%), and had invasive ductal carcinoma as histologic type (80.9%). Most cases (74.8%) were advanced at diagnosis (Stages III or IV) and the most common therapeutic modalities were chemotherapy alone (46.5%), and surgery combined with chemotherapy (44.7%). The 5-year survival rate was 51.9% and factors most strongly associated with poor survival included male gender (aHR: 7.07; 95% CI: 3.97 - 12.57; p < 0.001), advanced cancer stage (aHR: 4.92; 95% CI: 3.14 - 7.71; p < 0.001), and consultation delay ≥ 6 months (aHR: 2.20; 95% CI: 1.66 - 2.90; p < 0.001). Meanwhile, combining surgery and a second therapeutic modality, as well as university education was associated with better survival. Conclusion: This study highlights the high prevalence of advanced-stage disease, a modifiable factor, and its negative impact on BC survival in our setting. The findings underscore the need for strategies to enhance early detection, and timely combined treatment, as indicated, to improve BC outcomes.