Survival Analysis of Malaysian Women with Breast Cancer: Results from the University of Malaya Medical Centre

Background: Breast cancer is the commonest cancer amongst Malaysian women but local survival data arescarce. The present study was therefore conducted to assess overall survival and prognostic factors in Malaysianbreast cancer patients.
Methods: The research sample was a prospective cohort of 413 patients diagnosed withbreast cancer in the University of Malaya Medical Centre between 1993 to 1997. Survival data were obtainedfrom the National Registry of Birth and Deaths in December 2000. The clinico-pathological variables studiedwere age, ethnic group, stage, tumour size, lymph node status, oestrogen receptor status and grade. The datawas analysed utilizing Splus statistical software. The important prognostic factors were identified by fitting theCox’s proportional hazard model to the data set. Survival probabilities were estimated using the Kaplan-Meiermethod and differences were compared by the log-rank test.
Results: The overall 5-year survival was 59.1%.The Cox’s proportional hazard model identified stage, lymph node status, size and grade as factors that correlatedwith prognosis. Age was not a significant prognostic factor. The Cox regression model by stepwise selectionshowed stage, nodal status and grade of tumour to be independent prognostic factors, whereas ethnicity, ageand ER status were not. Interpretation: The overall survival in our centre was low. Recognizing factors thataffect prognosis of breast cancer patients in Malaysia may improve delivery of health care to at-risk groups bystrategizing interventions as survival depends on early detection and effective treatment.