Document Type: Research Articles
Department of General Surgery, Hospital Sultanah Nora Ismail, Batu Pahat, Johor, Malaysia.
Department of Surgery, University Malaya Medical Centre, Petaling Jaya, Malaysia.
Clinical Research Centre, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Objective: To gauge surgical outcome in breast cancer patients with particular reference to overall survival and
recurrence free survival among breast cancer patients in Hospital Sultanah Nora Ismail Batu Pahat, Johor, Malaysia.
Methods: Patients undergoing ablative breast cancer surgery were identified and clinical records were assessed.
Inclusion criteria for enrolment were stage I-IV breast malignancy necessitating resection with or without radiotherapy/
chemotherapy from 2007 to 2013. All individuals had a pre-operative assessment. The post operative assessment period
ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves. Results: A total of
121 patients were included in this study, with an age range of 28-78 years. Some 98% had undergone local excision/
lumpectomy/ mastectomy with axillary clearance. While 81% of patients underwent chemotherapy, only 69% had
radiotherapy. Tumours were oestrogen receptor positive in 58% of cases and progesterone receptor positive in 62%.
Local recurrence was detected in 10%. The mean age at diagnosis was 51.3 + 10.4 years. The overall survival analysis
was based on 22 deaths among the 121 patients (18.2%). Three-year and five-year survival rates were 87.6% and 78.4%,
respectively. Analysis of recurrence-free-survival (RFS) was based on 12 events among 121 patients. The Kaplan-Meier
RFS analysis revealed that in 90% of the patients with recurrence, it occurred within 45 months. The five year RFS
rate was 84.5%. The median time taken from diagnosis to ablative surgery was 51 days (upper limit of 791 days).
Only distant metastasis was a significant factor that impacted on both overall survival and recurrence-free survival
(p<0.001). Conclusion: Overall survival among our breast cancer patients in our facility is comparable to other in
other tertiary centres in the country. A trend for earlier detection was noted.