According to GLOBOCAN 2018, breast cancer is the most common cancer among women in Haiti. However, its trend throughout the years has not yet been studied. This study aims to present the four-year epidemiological trends of breast cancer managed by a cancer program in Port-au-Prince, Haiti.
A retrospective study was conducted on patients with breast cancer aged 18 years old (y/o) or more of the cancer clinic of Innovating Health International from January 2014 to December 2017. The chart review focused on variables such as age, gender, year of diagnosis, staging, estrogen receptor (ER) status and outcome. A systematic comparison between the years, age and ER status was performed. Overall mortality and loss to follow-up rates were also estimated.
Six hundred and sixty-two (662) cases of breast cancer, among them 659 women and 3 men, were selected for the study period, respectively 114 in 2014, 131 in 2015, 159 in 2016 and 258 in 2017 (p < 0.001). The mean age of the cohort was 50.7 years [20 –94], decreasing from 52.3 years in 2014 to 50.2 years in 2017 (p = 0.2). Patients under 40 y/o represented 21.4%% of this cohort, with the proportion increasing from 15.2% in 2014 to 24.5% in 2017 (p = 0.051). 92.3% of the staged patients (n = 595) had advanced breast cancer (stages IIB to IV). 30.8% of the patients had metastatic cancer, and the proportion decreased from 38.9% in 2014 to 25.7% in 2017 (p < 0.001). There was a higher proportion of MBC among Patients ≥ 40 y/o (32.5%) versus those < 40 y/o (24.6%) (p = 0.07). Of the patients with known ER status (n = 325), 56.9% were ER-positive, 52.4% among the < 40 y/o versus 58.1% among the ≥ 40 y/o (p = 0.41). The overall mortality rate was 35.5%, 35.5% among the <40 y/o versus 35.6% among the ≥ 40 y/o (p = 0.98). 14.8% of the patients were lost to follow-up. ER-negative patients were significantly more likely to die than ER-positive ones (Odds Ratio=1.91, p = 0.007).
There were a significant increase of breast cancer admissions and a decrease of metastatic cases from 2014 to 2017, due to a combination of increased awareness, incidence and referral. The breast cancer population became younger throughout the years, with more ER-negative cases among the < 40 y/o subgroup. ER-negative status was significantly associated with mortality.
Joseph Bernard Jr.
Has not received any funding.
All authors have declared no conflicts of interest.