Impact of Histopathological Profile on Disease Progression of Breast Cancer Patients during the 1st 1-2 Years follow-up: Evidence from the Philippine DOH-Breast Cancer Medicine Access Program

Marie Christine G. Semira,1 Joanne Marie L. Balbuena,1 Vanina Htun-Javier,2 
Jennifer Sandoval-Tan,1 Corazon A. Ngelangel,1,3 Anna Melissa S. Guerrero,4 
Rachel Marie B. Rosario3 and Romeo V. Marcaida3

1Section of Medical Oncology, College of Medicine and
Philippine General Hospital, University of the Philippines Manila
2Section of Medical Oncology, Jose Reyes Memorial Medical Center, Manila, Philippines
3Philippine Cancer Society, Manila, Philippines
4Department of Health-National Center for Pharmaceutical Access Management

Introduction. Current international concensus confirms that certain histopathologic factors such as tumor morphology, histologic grade and presence of lymphovascular invasion are correlated with prognosis. This retrospective cohort study evaluated the correlation between histopathologic profile and time to disease progression (TTP) within the first 1-2 years follow-up of Filipino Stage I-III early breast cancer patients.

Methods. This is a retrospective cohort study which included breast cancer patients enrolled in the Department of Health-Breast Cancer Medicine Access-Program (DOH-BCMAP) at the medical oncology clinics of two tertiary hospitals in Manila. Clinical and histopathologic factors were gathered from patient records, and the patients were grouped according to the modified St. Gallen definition of risk categories for patients with breast cancer. Kaplan-Meier survival analysis determined the average TTP as well as progression-free survival (PFS). Multivariate logistic regression determined factors contributing to disease progression.

Results and Conclusion. Of the 326 patients enrolled in this study, 18% showed progression with a median TTP of 14 months. TTP was comparable among the low-, intermediate- and high-risk groups. PFS during the 1st 1-2 years follow-up was estimated to be at 78% for the high-risk group, 83% for the intermediate-risk group, and 86% for the low-risk group. During this 1st 1-2 years follow-up, no studied factors of interest were shown to be significantly correlated with outcome among this predominantly intermediate to high risk for recurrence breast cancer patients. Follow-up of these patients up to 5 or more years would define sustained gains from the DOH-BCMAP.

Key Words: histopathological factors, breast cancer, TTP, Philippines