Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study

Abstract Background Breast cancer recurrence is a significant concern when the disease returns following surgery. The time to recurrence and factors affecting it are not well studied in low-income countries. This study aimed to assess the time to recurrence and predictors of breast cancer among wome...

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Main Authors: Yadessa Chala, Tesfaye Techane, Bonsisa Bekele, Tesfaye Girma, Warati Fekede, Chalchisa Abdeta, Kibiru Mardasa, Tolera Abdeta, Bedada Teshome, Gashaye Atinkut, Abdinasir Wako, Mohammed Adem, Alem Deksisa
Format: Article
Language:English
Published: Springer 2025-06-01
Series:Journal of Cancer Research and Clinical Oncology
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Online Access:https://doi.org/10.1007/s00432-025-06181-2
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author Yadessa Chala
Tesfaye Techane
Bonsisa Bekele
Tesfaye Girma
Warati Fekede
Chalchisa Abdeta
Kibiru Mardasa
Tolera Abdeta
Bedada Teshome
Gashaye Atinkut
Abdinasir Wako
Mohammed Adem
Alem Deksisa
author_facet Yadessa Chala
Tesfaye Techane
Bonsisa Bekele
Tesfaye Girma
Warati Fekede
Chalchisa Abdeta
Kibiru Mardasa
Tolera Abdeta
Bedada Teshome
Gashaye Atinkut
Abdinasir Wako
Mohammed Adem
Alem Deksisa
author_sort Yadessa Chala
collection DOAJ
description Abstract Background Breast cancer recurrence is a significant concern when the disease returns following surgery. The time to recurrence and factors affecting it are not well studied in low-income countries. This study aimed to assess the time to recurrence and predictors of breast cancer among women treated in public hospitals of Addis Ababa, Ethiopia. Methods Retrospective cohort study was conducted from April 30 to May 30, 2024, among randomly selected 322 recorded cases. The study covered from September 11, 2018, to September 12, 2023. Data were collected by the Kobo toolbox and analyzed by Stata Version 15. The Cox proportional hazard model was used to identify predictor variables, with assumptions checked using the Schoenfeld residual/global test (0.79). Multi-collinearity was checked using the variance inflation factor (3.72). Variables with a P-value < 0.25 in bivariable analysis were entered into the final multivariable analysis. Variables with a P-value < 0.05 at 95% confidence level were considered independent predictors of recurrence. Result The recurrence-free survival (RFS) status at the median follow-up time was 87.5%. The incidence rate of breast cancer recurrence was 6.8 per 100 women years (95%CI = 5.34–8.13) follow-up. The 75%RFS time was 44 months (95CI% = 40–48). The proportion of RFS survival at 24, 36, 48, and 60 months was 91.93%, 83.3%, and 67.7%, 61% respectively. Women aged 40 & below (AHR = 3.32; 95%CI 1.80–5.88), Overweight (AHR = 1.95, 95%CI 1.06 -3.59), surgical margin positive (AHR = 2.1; 95%CI 1.20–4.02), axillary node-positive (AHR = 1.98; 95%CI 1.08–3.61) and comorbidity (AHR = 4.45, 95%CI 2.39–8.30) were independent predictors for increased hazard of recurrence. Conclusion This study confirms a substantial incidence of breast cancer recurrence, with identifiable predictors including comorbidity, age, overweight, positive axillary node status, lymph node involvement, and deep surgical margin. Targeted interventions aimed at improving patient understanding of recurrence risk, promoting adherence to treatment protocols, and fostering healthy lifestyle modifications are crucial for reducing recurrence rates.
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series Journal of Cancer Research and Clinical Oncology
spelling doaj-art-e57bebce19be4f508b812b1d4f5cc59a2025-08-20T04:01:44ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-06-01151611210.1007/s00432-025-06181-2Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort StudyYadessa Chala0Tesfaye Techane1Bonsisa Bekele2Tesfaye Girma3Warati Fekede4Chalchisa Abdeta5Kibiru Mardasa6Tolera Abdeta7Bedada Teshome8Gashaye Atinkut9Abdinasir Wako10Mohammed Adem11Alem Deksisa12Madda Walabu University Goba Referral HospitalDepartment of Oncology, Saint Paul Hospital Millennium Medical CollegeDepartment of Oncology, Saint Paul Hospital Millennium Medical CollegeDepartment of Oncology, Saint Paul Hospital Millennium Medical CollegeDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeEarly Start, School of Education, University of WollongongDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeAdama Public Health Research and Referral Laboratory CenterDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeDepartment of Public Health, General Surgery, and Internal Medicine, Adama Hospital Medical CollegeAbstract Background Breast cancer recurrence is a significant concern when the disease returns following surgery. The time to recurrence and factors affecting it are not well studied in low-income countries. This study aimed to assess the time to recurrence and predictors of breast cancer among women treated in public hospitals of Addis Ababa, Ethiopia. Methods Retrospective cohort study was conducted from April 30 to May 30, 2024, among randomly selected 322 recorded cases. The study covered from September 11, 2018, to September 12, 2023. Data were collected by the Kobo toolbox and analyzed by Stata Version 15. The Cox proportional hazard model was used to identify predictor variables, with assumptions checked using the Schoenfeld residual/global test (0.79). Multi-collinearity was checked using the variance inflation factor (3.72). Variables with a P-value < 0.25 in bivariable analysis were entered into the final multivariable analysis. Variables with a P-value < 0.05 at 95% confidence level were considered independent predictors of recurrence. Result The recurrence-free survival (RFS) status at the median follow-up time was 87.5%. The incidence rate of breast cancer recurrence was 6.8 per 100 women years (95%CI = 5.34–8.13) follow-up. The 75%RFS time was 44 months (95CI% = 40–48). The proportion of RFS survival at 24, 36, 48, and 60 months was 91.93%, 83.3%, and 67.7%, 61% respectively. Women aged 40 & below (AHR = 3.32; 95%CI 1.80–5.88), Overweight (AHR = 1.95, 95%CI 1.06 -3.59), surgical margin positive (AHR = 2.1; 95%CI 1.20–4.02), axillary node-positive (AHR = 1.98; 95%CI 1.08–3.61) and comorbidity (AHR = 4.45, 95%CI 2.39–8.30) were independent predictors for increased hazard of recurrence. Conclusion This study confirms a substantial incidence of breast cancer recurrence, with identifiable predictors including comorbidity, age, overweight, positive axillary node status, lymph node involvement, and deep surgical margin. Targeted interventions aimed at improving patient understanding of recurrence risk, promoting adherence to treatment protocols, and fostering healthy lifestyle modifications are crucial for reducing recurrence rates.https://doi.org/10.1007/s00432-025-06181-2BreastCancerEthiopiaPredictorsRecurrence
spellingShingle Yadessa Chala
Tesfaye Techane
Bonsisa Bekele
Tesfaye Girma
Warati Fekede
Chalchisa Abdeta
Kibiru Mardasa
Tolera Abdeta
Bedada Teshome
Gashaye Atinkut
Abdinasir Wako
Mohammed Adem
Alem Deksisa
Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study
Journal of Cancer Research and Clinical Oncology
Breast
Cancer
Ethiopia
Predictors
Recurrence
title Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study
title_full Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study
title_fullStr Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study
title_full_unstemmed Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study
title_short Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study
title_sort time to breast cancer recurrence and associated predictors in public hospitals of addis ababa central ethiopia a retrospective cohort study
topic Breast
Cancer
Ethiopia
Predictors
Recurrence
url https://doi.org/10.1007/s00432-025-06181-2
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